Breaking Research News from sources other than Breastcancer.org
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I don't find that I have posted this... but I have been getting loads of emails about this online cancer conference. Some of the speakers sound interesting. Unfortunately, I haven't had much time to watch. Dates are Aug 5-15. Maybe some presenters will be available via recorded video later...?
Here is the promo material:
LEARN FROM 40+ CANCER SURVIVORS, METAVIVORS, CAREGIVERS AND MEDICAL EXPERTS ABOUT DIAGNOSIS, TREATMENT AND THE AFTERMATH SO YOU CAN KEEP YOUR SPIRIT INTACT & SHARE YOUR TRIUMPH!
Join us for this free, virtual event and get your questions answered. Learn from women just like you as they share how they made decisions about treatment and discuss how the emotional effects of diagnosis impact them today.
This event brings together the best doctors, therapists, nonprofits, fashion brands, comedians, podcasters, survivors and metavivors teaching you how to get through diagnosis, treatment and the aftermath helping keep your mind and spirit intact!
There ARE so many awesome stories of TRUE WARRIORS SHARING TRIUMPH!
If you know someone dealing with a cancer diagnosis and the emotional aftermath, forward them this email and encourage them to Get Their Free Conference Pass:
https://conference.sharetriumph.com/joinThe conference also has a Facebook page:
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BRCA Mutation, Preventive Surgery, and Osteoporosis
— Researchers advocate for increased hormone therapy for high-risk women
Bone health suffered in women with a BRCA mutation who underwent preventive oophorectomy, Canadian researchers reported.
Premenopausal women with the BRCA1 or BRCA2 mutation experienced a significant decline in bone mineral density (BMD) after undergoing prophylactic bilateral salpingo-oophorectomy...
"These pre-menopausal women looked a lot like post-menopausal women after a year following surgery,"
...use of hormonal therapy was able to offset most of the deleterious bone changes in both pre- and post-menopausal women after surgery.
"There are no standardized guidelines for the management of bone health in this population after surgery,"
"Given the important role of estrogen in maintaining various physiological functions, including bone health, this rate of hormone therapy use is far too low," the researchers stated, suggesting that the "mitigating effects" of hormone therapy use in this population should be noted in future clinical practice guidelines.
...suggested recommending enough calcium intake for this population, as well as engaging in weight-bearing exercise and exogenous hormone use for those for whom it is not contraindicated.
future studies with a longer follow-up period are needed to truly estimate the impact of prophylactic bilateral salpingo-oophorectomy on fracture risk in this high-risk population of women.
Primary Source
JAMA Network Open
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Patients with cancer- or treatment-related fatiguemight want to check out Untire, a free fatigue management app available from England's National Health Service.
https://www.nhs.uk/apps-library/untire-beating-cancer-fatigue/
{I haven't tried this. Please share your expereince if you do.}
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Validation of Microsatellite Instability Detection Using a Comprehensive Plasma-Based Genotyping Panel
Another liquid biopsy showed good correlation with tissue biopsy, this time for detection of microsatellite instability, which can influence treatment decisions for multiple types of cancer. (American Association for Cancer Research)
Conclusions: cfDNA-based MSI detection using Guardant360 is highly concordant with tissue-based testing, enabling highly accurate detection of MSI status concurrent with comprehensive genomic profiling and expanding access to immunotherapy for patients with advanced cancer for whom current testing practices are inadequate.
https://www.aacr.org/Newsroom/Pages/News-Release-Detail.aspx?ItemID=1328
https://clincancerres.aacrjournals.org/content/early/2019/08/02/1078-0432.CCR-19-1324#
DOI: 10.1158/1078-0432.CCR-19-1324
{Lots of breaking news on liquid biopsies. I don't believe that this one has been posted before.}
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England's healthcare cost-effectiveness agency, NICE, also had a busy week, approving.....neratinib (Nerlynx) for certain patients with HER2-positive breast cancer...
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New 'don't eat me' signal may provide basis for cancer therapies
Cancer cells are known to protect themselves using proteins that tell immune cells not to attack them. Stanford researchers have discovered a new "don't eat me" signal, and blocking it may make cancer cells vulnerable to attack by the immune system.
... they implanted human breast cancer cells in mice. When CD24 signaling was blocked, the mice's scavenger macrophages of the immune system attacked the cancer.
Of particular interest was the discovery that ovarian and triple-negative breast cancer, both of which are very hard to treat, were highly affected by blocking the CD24 signaling. "This may be a vulnerability for those very dangerous cancers,"
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Association between meat consumption and risk of breast cancer: Findings from the Sister Study
Meat consumption has been postulated to increase the risk of breast cancer, but this association has not been consistently seen.
We examined the association between consumption of different types of meat, meat mutagens and incident invasive breast cancer .
In a substitution model with combined red meat and poultry consumption held constant, substituting poultry for red
meat was associated with decreased invasive breast cancer risk. No associations were observed for cooking practices, estimated heterocyclic amines or heme iron from red meat consumption with breast cancer risk. Red meat consumption may increase the risk of invasive breast cancer, whereas poultry consumption may be associated with reduced risk. Substituting poultry for red meat could reduce breast cancer risk.
{Cannot locate a DOI - sorrry}
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Medicare to Cover Pricey Cancer Tx Nationwide
Ups reimbursement to 65% and allows for guideline-recommended off-label use
The Centers for Medicare & Medicaid Services (CMS) on Wednesday announced nationwide coverage of an exciting but also very expensive new cancer treatment -- chimeric antigen receptor (CAR) T-cell therapy -- for Medicare recipients with certain types of lymphoma and for any expanded indications down the round.
Prior to the decision, coverage for CAR-T therapy carried uncertainty and was decided by regional Medicare administrators.
{Complicationg factor:} CMS has now put providers in a difficult position.
"They are required to provide this therapy, but the Administration is providing very little help to cover its high costs," Silverstein said. "The Administration's final inpatient rule, announced last week, does not do enough to adequately reimburse institutions for the cost of care or the cost of the product."
{This article reminded me of Judy Perkins, the stage 4 breast cancer patient who remains cancer free 2 years after treatment with a new, experimental treatment. It is my understanding that that therapy used her T-calls but was a different technique. "CAR-T only works in blood cancers.... A different tactic is needed for solid tumors, such as breast cancer. And even though it is very expensive and very complicated, CAR-T can be successful, he noted. "It's a whole different way of thinking about cancer treatment," It is encouraging that CAR-T is now being covered by Medicare.}
{quote from https://www.nbcnews.com/health/health-news/highly-personalized-treatment-saves-breast-cancer-patient-n879841}
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Air pollution is linked to poor survival after breast cancer diagnosis
The effect of atmospheric particulate matter on survival of breast cancer among US females
Results showed that patients living in counties with high levels of PM had an increased risk of early mortality. The risk of early mortality was increased by 33% for patients living in counties with increased pollution levels of large particles, and increased by 40% for patients living in counties with increased pollution levels of small particles. These results remained significant even after researchers accounted for social and economic differences between counties. Air pollution was related to increased risk of early mortality especially in early-stage cancer patients, and to a lesser degree in advanced-stage cancer patients.
https://link.springer.com/article/10.1007%2Fs10549-013-2527-9
DOI https://doi.org/10.1007/s10549-013-2527-9
{Egad! The pollution is going to kill us, too! With effects that large, makes you wonder if it is cause the problem to begin with.}
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This isn't new, but it's an interesting video on how macrophages, supposedly some of our immunity good guys, can actually help the bad guy cancer cells to spread.
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Thanks Lumpie and Santabarbarian, I'll look for resveratrol capsules from a good source. I'll report back if they help.
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Calcium channel blocker and risk of lymphedema among breast cancer patients: nested case control study
Amanda J Stolarz, Mrinmayee Lakkad, V Suzanne Klimberg and Jacob T Painter
https://cebp.aacrjournals.org/content/early/2019/08/09/1055-9965.EPI-19-0448
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Lumpie - thank you. Now I know what to call it. Contralateral Lymphedema. Google now finds what I am looking for instead of reminders to do BP and other constricting things on the opposite side. The left side healed a lot better than right, where there is a pronounced scar. I guess I should not have shoveled snow that winter. I asked the lymphatic therapist whether that might contribute, and she did not think so, that she had seen much heavier scarring. I think the surgeon was a good one, and did not compromise the non-cancer side. The oncologist ordered a CT scan, expect results in another week or so. Both the oncologist and therapist think it is very unusual, but for now, the treatment seems to be the same. Lymphatic sleeve and glove, and self-massage at home. The therapist also uses a sleeve which pumps the arm gently. Has anyone figured out an easy way to do the measurements? Even when I tape the tape measure to the arm , it is clumsy, and not very reliable. Looking at my arms I see everything from improvement, to getting worse, to no change. Perception can be deceiving. At first it went down, very slightly, then went back up. But it is definitely not as tight as it used to be.
2009 ER+ left breast. 52 yrs. Lumpectomy, Sentinel node removal, negative. Radiation 6 weeks, tamoxifen 5 years. Dense lumpy left breast, normal right. Acupuncture offered at facility as part of integrative medicine. It really helped with anxiety/stress during radiation treatment.
2016 ER+ left breast. Probably a new cancer, but unknown. 4 rounds TC Aug-Oct 2016, Bi-lateral (my choice) Nov 2016, no reconstruction. 2 sentinel nodes remove, negative. Cold Capping using Chemo Cold Caps (DIGNICAP not available). Anastrozole 1 mg starting May 2017. Joint issues noticed immediately. Stopped Anastrozole after 3-4 months due to joint stiffness in. After several months of no AIs, fingers were feeling better. Started tamoxifen March 2018
10/2018 noticed stiffness and some trigger finger again. Was eating meat a lot more (daily) than normal. Usually 1-2 /wk. Have cut way back on the meat, seems to help, but one finger still very prone to trigger finger. Trigger finger seemed to be getting better, but now 4/2019 seems worse, is it the break from added turmeric to meals?
7/19/2019 - swelling in R-arm, opposite side from where lymph nodes removed (contralateral lymphedema). Noticed 6/18/2019. Could have been swelling earlier but wearing long sleeves. Trip to urgent care. They did ultrasound, concerned that there might be a clot, there was not. Started seeing lymphatic therapist 7/2/2019.
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Blue Girl: If no one has yet shared this site, it is a wealth of information about LE. Several of our BCO members helped get it going.
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I tried the Untire App as part of a university research study. Unfortunately, I very quickly got bored and found it was too generic i.e. not personalised enough for me. Just my opinion of course, others may want to have ago and pitch in with their thoughts
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Ladies: I follow this thread with great interest. Thank you for all the work and research done to bring this information to light.
I have a question regarding BC research and collection of outcome data in general. I was wondering if all of our data is swept into large databases anonymously so that these large studies can be done. So, when results for risk models and prediction calculators are published, they include the thousands of data points that we all represent (and that our doctors rely upon). It just seems logical that all these patient outcomes would be collected and analyzed somewhere.
Did I sign something when I was diagnosed that allows my doctors to contribute my data to the collective data monster? How we each fare on our various treatment plans and whether we have recurrences on those plans, is someone collecting that data (hopefully, anonymously)? I actually hope my data IS used along with thousands of others, because it would seem to make treatment and diagnosis decisions better each year for every new patient. But I've never asked my docs about this.
I would be very interested to know.0 -
Diveslikeagirl: I am not an expert on cancer databases but I know a little. Cancer statistics are collected in the SEER database. It is part of NIH and NCI. I believe that providers are not required to collect an authorization to report health information because reporting is government mandated. Frankly, I don't know the details of anonymity but researcher-users are required to sign a pledge not to reveal or seek to personally identify individuals in the database. You can read more about SEER here:
Additionally, many cancer centers/large medical centers maintain their own database for research purposes. If you are treated at such a center, you might ask about their data collection practices and how they facilitate research. People who specialize in maintaining these databases are "cancer registrars."
People have numerous opinions on and criticisms of the maintenance of these databases. For example, I know that, historically, SEER has only tracked one's first breast cancer diagnosis. They have not tracked later development of metastasis so the data on metastatic cancer is woefully lacking. There has been a great deal of advocacy around this issue - including a push to require collection of information related to any stage 4 diagnosis which follows an early stage breast cancer diagnosis.
Many of us agree that we would very much like for our experiences, including diagnosis and treatment, to be documented if that information may improve outcomes of others who develop cancer in the future.
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Results From the First Multicenter, Open-label, Phase IIIb Study Investigating the Combination of Pertuzumab With Subcutaneous Trastuzumab and a Taxane in Patients With HER2-positive Metastatic Breast Cancer (SAPPHIRE)
The primary objective of this study was to assess the safety and tolerability of combination pertuzumab, subcutaneous trastuzumab (Herceptin), and investigator's choice of taxane chemotherapy in previously untreated patients with human epidermal growth factor receptor 2-positive metastatic breast cancer. Efficacy was a secondary objective.
This study was an open-label, non-randomized study of patients with human epidermal growth factor receptor 2-positive metastatic breast cancer who had no previous systemic non-hormonal anti-cancer therapy for metastatic disease. The primary endpoints included adverse events (AE), serious AEs, and cardiac AEs. Secondary endpoints included overall response rate, progression-free survival, and overall survival. Patients were treated with pertuzumab and subcutaneous trastuzumab in 3-weekly cycles with taxane chemotherapy until disease progression, unacceptable toxicity, or withdrawal of consent and followed for a minimum of 24 months from initiation of study treatment.
Subcutaneous trastuzumab in this combination has an acceptable safety and tolerability profile, including cardiac safety profile. Safety and efficacy appear similar to previous studies of intravenous trastuzumab in this combination.
https://www.clinical-breast-cancer.com/article/S1526-8209(18)30696-7/fulltext
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Pay-to-Play Clinical Trials
Federal regulators are paying more attention to "pay-to-play" clinical trials that offer admission for a price, STAT reports.
The FDA confirmed to STAT that it asked an advisory committee to consider how the research community should think about these kinds of trials, and the panel is now drafting recommendations, according to the story. The National Institutes of Health has asked the committee to assess whether its existing guidance to patients considering a clinical trial would apply in this situation.
Both groups' actions follow the HHS Secretary's Advisory Committee on Human Research Protections' (SACHRP) consideration of pay-to-participate trial guidance. SACHRP is expected to release guidelines at its next meeting in December, or the following one in March. It took an interest in the subject last year following a plan in Florida to charge seniors a fee -- as high as $285,000 -- to enroll in a trial of "young blood" infusions for preventing aging.
There are no data on whether or not these types of trials are increasing, but more examples have cropped up recently, including another trial of "young blood" that charged about 80 people $8,000 each for infusions, and a clinic in Panama enrolled 20 autistic children in a stem cell trial that charged parents $7,200, STAT reports.
While FDA regulations permit a clinical trial "entry fee" in certain situations, the concern is that this could serve as a rouse for an entity looking to profit from desperate patients.
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Tracking Candida auris
Candida auris is an emerging fungus that presents a serious global health threat. C. auris causes severe illness in hospitalized patients in several countries, including the United States. Patients can remain colonized with C. auris for a long time and C. auris can persist on surfaces in healthcare environments. This can result in spread of C. auris between patients in healthcare facilities.
Most C. auris cases in the United States have been detected in the New York City area, New Jersey, and the Chicago area. Strains of C. auris in the United States have been linked to other parts of the world. U.S. C. auris cases are a result of inadvertent introduction into the United States from a patient who recently received healthcare in a country where C. auris has been reported or a result of local spread after such an introduction.
Candida auris was made nationally notifiable at the 2018 Council for State and Territorial Epidemiologists (CSTE) Annual Conference. For the updated case definition and information on the nationally notifiable condition status, please see the 2018 CSTE position statement.
CDC encourages all U.S. laboratories that identify C. auris to notify their state or local public health authorities and CDC at candidaauris@cdc.gov. CDC is working closely with public health and healthcare partners to prevent and respond to C. auris infections. The CDC-sponsored Antibiotic Resistance Laboratory Network (ARLN) will help improve detection and response to C. auris nationwide.
{This is rather technical but strains of multi-drug resistant C. auris have been identified in the U.S. The public should be aware and those with compromised immune systems may wish to take note.}
https://www.cdc.gov/fungal/candida-auris/tracking-c-auris.html
https://www.cdc.gov/fungal/candida-auris/index.html
https://www.cdc.gov/drugresistance/solutions-initiative/stories/cdc-response-to-global-threat.html
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Advanced HER2-Positive Breast Cancer: All Eyes on These Novel Agents
NEW AGENTS for the treatment of advanced HER2-positive breast cancer should be coming soon to your clinic... Clinicians can expect new agents soon. "The landscape may change in a year or 2," Dr. Hurvitz predicted at the 2019 Miami Breast Cancer Conference.1 "There are some very promising agents that may become available for later lines and may actually challenge the treatment paradigm we currently follow."
{This is from April but I don't beleive that the link has been posted.}
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AZ announces Phase I DS-8201 results
AstraZeneca has announced two Lancet Oncologypublications of its Phase I dose-expansion results of DS-8201 (trastuzumab deruxtecan) in HER2-positive metastatic breast and gastric cancer.
The breast cancer trial found a confirmed objective response rate of 59.5% and a disease control rate of 93.7% at a recommended expansion dose of 5.4 or 6.4 mg/kg. There was also a 20.7 months median duration of response in HER2-positive metastatic breast cancer patients previously treated with trastuzumab emtansine... Patients enrolled in this part of the trial had a median of seven prior lines of treatment, including trastuzumab and trastuzumab emtansine, and in 86% of cases, pertuzumab.
"For patients with HER2-positive metastatic breast cancer that progresses after trastuzumab, pertuzumab, and trastuzumab emtansine, optimal treatment is not clearly defined and choices may be limited. These results demonstrate preliminary clinically-meaningful response rates with an impressive duration of response, supporting further development and suggesting a potential role for trastuzumab deruxtecan as a HER2-targeted therapy option in this setting,"
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About cancer databases: A month or two ago, I received an invitation by mail to participate in a survey of breast cancer patients from a certain demographic. The letter was from a local NCI cancer center in partnership with my state's health dept. The letter explained that my name was obtained from the state cancer database. I was a bit surprised, because I was also unaware that my personal information was being stored in a state database. I have no idea if paperwork I have signed revealed this. I would have signed anything to make the treatment begin when I was first diagnosed. And, they have those electronic signature deals at my cancer center, where you don't really get to read everything before they give you the pad & pen to sign.
I have since found out that my state also participates in SEER. I wonder how much information is disclosed to them. Yes, I do want to be counted and have my data used in research but how much personal identifying information about me is being stored and distributed?
On another note - this thread is so fantastic! Big thank you to Lumpie and others who regularly contribute. What an amazing gold mine of information you ladies have created!
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Long-Term Comparison of Aesthetical Outcomes After Oncoplastic Surgery and Lumpectomy in Breast Cancer Patients
Lumpectomy may result in major deformities and asymmetries in approximately one-third of patients. Although oncoplastic surgery (OP) could be a useful alternative to avoid them, lack of strong data is causing some debate. The purpose of this study was to compare aesthetic outcomes in patients undergoing OP versus lumpectomy using three different assessment methods.
Methods
A total of 122 patients were included in this cross-sectional multicentric study; 57 underwent OP (46.7 %), and 65 underwent lumpectomy (53.3 %). Two breast surgeons and two plastic surgeons from different institutions using the Garbay scale independently evaluated aesthetic outcomes. BCCT.core software was applied in both groups, and the patients evaluated their aesthetic outcomes answering a questionnaire about their satisfaction rate.
Results
OP group had a higher proportion of excellent aesthetic results according to the BCCT.core software analysis (p = 0.028) and the specialists (p = 0.002). Multifactorial analyses showed that age ≥70 years (RP = 6.02; 95 % confidence interval [CI] 1.73–21.0; p = 0.005), tumors in the medial, inferior, and central quadrants (RP = 4.21; 95 % CI 1.88–9.44; p < 0.001), and large breasts (RP = 7.55; 95 % CI 2.48–23.0; p < 0.001) were significant risk factors for poor aesthetic outcomes after lumpectomy. The patients classified their results as better than those by the specialists and by the software, with no statistical difference between the groups.
Conclusions
Excellent aesthetic results were more frequent in the OP group according to BCCT.core software analysis and specialists. In addition, some clinical conditions and tumor locations in the breast can be considered risky factors for poor aesthetic outcomes in lumpectomy.
https://link.springer.com/article/10.1245%2Fs10434-014-4301-6#citeas
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Flavonoids in Plants May Help Protect Against Major Killers
August 19, 2019 4:58 pmConsuming flavonoids, a large class of nutrients found in plant foods, may reduce the risk for cancer and cardiovascular death.
Researchers used data on 56,048 Danes, following their diet and health prospectively for 23 years. During that time, 14,083 of them died. The study is in Nature Communications.
After controlling for smoking, hypertension, cholesterol and many other health and dietary factors, they found that compared with people in the lowest one-fifth for flavonoid intake, those in the highest one-fifth had a 17 percent reduced risk for all-cause mortality, a 15 percent reduced risk for cardiovascular disease death, and a 20 percent reduced risk for cancer mortality. The association peaked at about 500 milligrams of flavonoids a day, and was stronger for smokers, heavy drinkers and the obese.
Good sources of flavonoids include tea, chocolate, red wine, citrus fruits, berries, apples and broccoli. One cup of tea, one apple, one orange, and three-and-a-half ounces each of blueberries and broccoli would supply more than 500 milligrams of total flavonoids.
"Participants with a higher flavonoid intake also tended to have a healthier diet over all," said the lead author, Nicola P. Bondonno, a postdoctoral fellow at Edith Cowan University in Perth, Australia. "But flavonoids were still associated with a lower risk of death after adjusting for other dietary components, as well as within the group of participants with the highest fruit and vegetable intakes."
Source: NYT
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Daiichi Sankyo Confirms Plans to Accelerate BLA Submission to U.S. FDA for [Fam-] Trastuzumab Deruxtecan (DS-8201) in HER2 Positive
(March 28, 2019) – Daiichi Sankyo Company, Limited (hereafter, Daiichi Sankyo) today announced plans to accelerate filing of the Biologics License Application (BLA) with the U.S. Food and Drug Administration (FDA) for [fam-] trastuzumab deruxtecan (DS-8201), an investigational HER2 targeting antibody drug conjugate (ADC), in patients with HER2 positive metastatic breast cancer previously treated with ado trastuzumab emtansine
(T-DM1). Submission of the application, which was originally planned for 2020, is now scheduled for the first half of fiscal year 2019.
{Not super new but interesting. I gather that this application may have been delayed to fall 2019.}
https://www.daiichisankyo.com/media_investors/media_relations/press_releases/detail/006986.html
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About next-gen cell-based cancer therapies, and the clinical and economic challenges they pose. "But the patient who enters the operating room for a mastectomy, or is infused with CAR-T cells, emerges permanently changed, anatomically, physiologically, or genetically. And she is, in a way, a collaborator in the treatment as well as its subject."
https://www.newyorker.com/magazine/2019/07/22/the-promise-and-price-of-cellular-therapies
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Researchers convert pro-tumor macrophages into cancer killers
(Research on pancreatic and lung cancer but most bc is epithelial)
Epithelial cancers, such as cancers of the lung and pancreas, use the ανβ3 molecule to gain drug resistance to standard cancer therapies and to become highly metastatic. In a paper published in Cancer Research, University of California San Diego School of Medicine researchers identified a new therapeutic approach in mouse models that halts drug resistance and progression by using a monoclonal antibody that induces the immune system [tumor-associated macrophages (TAMs)] to seek and kill ανβ3-expressing cancer cells...
During the study period, no tumor progression or drug resistance was detected while untreated animals developed tumor growth and metastasis...
The antibody prompts these macrophages to begin killing tumor cells through a mechanism known as antibody-dependent cytotoxicity (ADCC).
"These results were initially unexpected since macrophages usually destroy cells via phagocytosis... The therapeutic antibody we are utilizing is bridging the macrophage to the ανβ3-expressing tumor cell as a target. When this occurs it releases a cytotoxic substance that kills the tumor cell."
The team is currently producing a humanized version of this antibody, which Cheresh hopes will do in humans what LM609 does in mice.
Article https://www.sciencedaily.com/releases/2019/08/190821125527.htm
Study at https://cancerres.aacrjournals.org/content/early/2019/08/15/0008-5472.CAN-19-1246
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Researchers Find Full Chemotherapy Dose Is Best for Common Type of Breast Cancer
Researchers looked at the impact of reducing chemo doses after breast surgery (called adjuvant therapy) using a combination of four different drugs: 5-fluorouracil, epirubicin, cyclophosphamide, and docetaxel (FEC-D). The drugs were given in four to six treatments cycles.
The study found that both the overall and 5-year disease-free survival rate was worse in those who received less than 85 percent of the recommended chemotherapy dose over six treatment cycles.
"What surprised us the most was how dramatically early reductions in chemotherapy affect survival compared to later modifications," said Dr. Zachary Veitch, from the department of oncology in the University of Calgary Tom Baker Cancer Centre, in a statement...
Although, when researchers split the lower-dose group in two based on dose reduction during the first three cycles versus the last three, they found the outcomes weren't worse when doses were reduced during the later cycles.
"The majority of cancer cells that are sensitive to chemotherapy may be killed in the first few treatments, rather than in the later treatments. Thus, reducing the dose late may not have as much of an impact," Veitch speculated in the statement.
Article: https://www.healthline.com/health-news/high-doses-of-chemotherapy-best-for-certain-breast-cancers
More detailed article: https://www.newswise.com/articles/maintaining-full-doses-of-chemotherapy-can-be-key-for-breast-cancer-survival-according-to-new-research-in-jnccn/sc-mwhr
Study: https://jnccn.org/view/journals/jnccn/17/8/article-p957.xml
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