Breaking Research News from sources other than Breastcancer.org
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Lumpie - thank you for the Washington Post link. A lot of misinformation and out right lies out there. Already confusing with the rapidly changing diagnosis and treatment of cancer, and the varying degree of success for each INDIVIDUAL. Sometimes I get discouraged hearing the "adds" from various cancer centers / cancer research centers that sponsor NPR. It sounds like there are individualized successful treatments, and for most, this just is not true. But the science is rapidly evolving, and maybe, someday there will be.
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Public service announcement (not exactly breaking news):
If you live in the Baltimore/Washington area, I just got an update from the Cancer Research Institute (very pro immunotherapy) regarding an information session they are doing in Baltimore on Saturday, Nov. 16th from 10-3:30. It is free and looks quite interesting. The main speaker is Dr. Elizabeth Jaffee, the co director of the Sidney Kimmel Cancer Center at Hopkins. They are also going to have navigators there to talk with you about possible clinical trials. You can google Cancer Research Institute to get further info.
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For some cancer patients, monitoring symptoms can extend their lives
A growing body of research has found that people with cancer who are routinely prompted to answer questions about their symptoms may live months longer and have a higher quality of life than people who don't track their symptoms as closely...
The results [of a new study analysing results from over 120,000 matched pairs of patients who were/were not surveyed about symptoms], published in May, were startling. Patients who answered the survey were less than half as likely to have died during the study period than people who never answered the questions.
Until the past few years, the idea that a patient's experience could be measured and then inform treatment decisions was seen as being too nebulous to be useful in treating cancer...
[An RCT published in 2017] found that people who reported their symptoms via the online program lived, on average, five months longer than people who didn't... [Another RCT published in 2017] reported in their preliminary analysis that patients who monitored symptoms lived, on average, seven months longer than patients who didn't. Earlier this year, their final analysis confirmed that survival benefit...
Wong said many institutions around the world have launched new programs to capture patient-symptom data with varied success.
https://www.washingtonpost.com/health/for-some-can...
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Targeting metastatic breast cancer with CAR T-cell immunotherapy
A team of researchers from Fred Hutchinson Cancer Research Center and its partner institutions, University of Washington and Seattle Cancer Care Alliance, just received a coveted Department of Defense Breast Cancer Research Program Breakthrough award.
The four-year, $4 million award, led by principal investigators Drs. Cyrus Ghajar and Stanley Riddell of Fred Hutch, will launch an innovative investigation aimed at preventing late-onset, metastatic breast cancer. The team is developing an immunotherapy strategy utilizing immune cells called T cells that are armed with tumor-targeting chimeric antigen receptors, or CARs...
Ghajar's research, along with that of his postdoctoral researchers Goddard and Grzelak, focuses on disseminated tumor cells, or DTCs, the tumor cells that can lie dormant in breast cancer patients for years or decades after treatment for early stage disease before emerging as metastasis...
Using new advances in protein design developed in the Baker Lab at UW, the researchers believe it is possible to engineer unique, customizable CARs that will be highly specific for DTCs and can direct T cells to kill them.
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On chemo helping the cancer spread, here is an interesting article from the website Science Based Medicine that explains the nuances in those results. The article takes issue with some promoters of alternative remedies that used that study to peddle their stuff. Skip that part and you will find a very good analysis of what these results say about chemo and cancer spread.
https://sciencebasedmedicine.org/does-chemotherapy-cause-cancer-to-spread/
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Hi all,
the deadly results and statistics of conventional therapies speak for themselves...I can't believe that any intelligent person would defend the status quo, where 30% of stage 1 BC patients will eventually be diagnosed stage 4...
Instead of defending chemotherapy, they should work harder at finding treatments that not only work, but don't require that we lose life and limbs in the process...
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Frisky - what is your source for that 30% of Stage I patients progressing to Stage IV number? People keep quoting that number but nobody has been able to produce a study showing that. At best, people come up with references to other people who have also quoted the number without backing it up. It seems like this 30% number that everybody throws around is based on something one single person said many years ago, also with no study to back it up. If you look at the actual number of women diagnosed with breast cancer every year vs. the number dying of it every year, that works out to ~15%. So if 100 women are dx'd with breast cancer at any stage in a given year, 15 will die of it in the same year. And the 100 women includes the 6-10% of women who are stage IV de novo. So are there scores of women getting stage IV breast cancer who go on to die of other causes? I don't understand how these numbers can add up.
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To begin with, that would be 20%- 30% of early stage, which includes stages one through three, not just stage one.
I don't want to derail this thread. There is a discussion of this figure on the web site of Metastatic Breast Cancer Network, a reliable source in my opinion. There is also a long BCO thread on the topic.
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Here's an article about the issue of provenance of that statistic:
https://www.medscape.com/viewarticle/849644#vp_1
Upshot: the origin of the stat appeared to be iffy:
a 1989 study of 644 patients with stage I (T1N0M0) or stage II (T1N1M0) breast carcinoma, all treated with mastectomy (J Clin Oncol. 1989;7:1239-1251). During the median follow-up of 18 years, 148 patients (23%) died of recurrent breast carcinoma.
Dr van't Veer and her colleagues presumably rounded their figures up (from 23% to 33%) because the referenced population included only patients with stage I and II disease, and therefore did not comprise all early-stage disease.
According to the National Cancer Institute (NCI), the definition of early-stage breast cancer is that which has not spread beyond the breast or the axillary lymph nodes. The range includes stage I, stage IIA, stage IIB, and stage IIIA disease.
So this particular 30%-ish statement from Dr van't Veer and colleagues appears to be an estimate based on a clinical study that is not contemporary. In short, it is not strong evidence.
The article goes on to describe an informal analysis of SEER data:
They looked at breast-cancer-specific mortality (as identified on death certificates) in 12 health districts in the United States from 2008 to 2012. They were surprised by the finding: "28% of the women who died of breast cancer during that time period had localized disease at diagnosis," said Dr Brawley.
But that's not the same as the percentage of early stage beast cancers that progress.
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Wow I didn't expect a furious reaction after posting additional information to help put in context the terrifying assertion that neoadjuvant chemo causes cancer cells to spread and fuels metastases. Here is my takeaway from the article, which is hard to disprove:
<<Tumor cell dissemination as a result of chemotherapy reduces, not eliminates, the benefit of neoadjuvant chemotherapy, and it certainly does not "make cancer spread" in such a way that neoadjuvant chemotherapy is worse than no chemotherapy.>>
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Unfortunately SEER counts people with de novo stage four breast cancer, but does not count people who had stage one, two, or three and then had a metastatic recurrence. The recurrence is ignored.
Again, I recommend reading the section about mbc statistics at MBCN. Org. There are sources cited for the information and a discussion of why the figure is hard to pin down.
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Hapa..for me it's very simple...what are my odds of surviving stage 4? I'm being treated at MSK, and my various MOs there have NEVER EVER given me any hope...mind you...till a few months ago I had Mets only in the bones...I have progressed with Mets to the liver while being treated...some might find this okay...I find this disheartening....
As far as the 20 or 30% progressing...it's a well known fact, that's being accounted—surely optimistically—for by our conventional cancer institutions.
As far as this web site is concerned, most of the people still alive after 5 years are on Herceptin, which seems to be the only reliable treatment...and yet, recently one of our members that is on Herceptin came up with depressing statistics...better than the non HER2 disasters, but still disarming...
Also, this site is another precious source of information regarding progression from early stages, all you have to is read the info at the bottom.
Ultimately, we are all free to chose what to believe and I respect anyone that thinks the odds are improving...yes that could be true....but in comparison to what?
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frisky, just wanted to sympathize; any kind of breast cancer sucks; chemo is brutal; metastatic breast cancer sucks exponentially more than non-metastatic breast cancer; breast cancer is a formidable challenge for medicine; it is phenomenally complex and the more we learn about it, the more complex it becomes. I am also for science and data and evidence-based medicine, and in my view alternative therapies are alternative not because they are an alternative, but because they cannot be proven to work by any reasonable standard -otherwise, they would become mainstream and conventional. To me, beyond science and reason and evidence, there simply is no alternative.
That article about neoadjuvant chemo causing spread doesn't mean one is better off without chemo. No need to terrorize us even more than we already are.
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laughingull I didn't mean to scare anyone, the reality of the scientific facts and statistics are scary enough...the problem is that since I'm no longer disassociated from reality, I can no longer avail myself of the usual coping mechanisms.
I ultimately believe that knowledge will serve me better than soothing notions.
you're right...we don't really have any viable choices..all are known to be at best unreliable ..otherwise why would cancer, and better yet, cancer treatments be so terrifying?
and maybe not...I'm sure there are some people that can easily cope with the surgery, radiation, chemo...and the next ten years of estrogen suppression....I do ultimately wish you and everyone else a fearless experience and successful outcome.0 -
frisky,
I agree, knowledge is power. Much love and peace,
LaughingGull
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Novel Surgery May Prevent Lymphedema in Patients with Breast Cancer
"Immediate lymphatic reconstruction is a preventive procedure to restore lymphatic connections in the arm," said Frederic Kolb, MD, plastic surgeon at UC San Diego Health. "This delicate surgery is performed at the same time the lymph nodes are removed and tested for cancer. Instead of treating patients after lymphedema presents itself, we hope to prevent the condition for patients who may be at risk."
During lymph node dissection, Kolb and his team map the drainage routes of the nodes in the upper arm. The team reconnects any disrupted channels by creating a "by-pass" to prevent swelling. Using a microscope, the team reroutes the tiny vessels, many less than the thickness of a dime...
"As a cancer surgeon, my primary goal is to accurately stage the cancer to identify which patients need more aggressive treatment," Sarah Blair, MD, surgical oncologist at UC San Diego Health. "In some patients, significant lymph node dissection can unintentionally result in damage to healthy tissue. With this procedure, we can help prevent lymphedema and give the patient a better overall experience and outcome."
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Pharma's Ghost Labs Find New Life
Finding new tenants for former drug development sites isn't always easy. But a new, thriving industry has materialized to do just that.
Big Pharma has also changed how it conducts R&D. To cut costs, companies are doing less of their own research and are instead relying on making deals with smaller companies or university research divisions that have already successfully developed drug candidates or therapeutics, and often working with contract research organizations on the continued development of those products. "The old 'make what you sell, sell what you make' is no longer the preferred strategy,"
{Article is about real estate but has implications for pharmaceutical development, too.}
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debbew - thank you for posting the link for novel surgery and preventing lymphedema. One more question to ask the surgeon tomorrow. This is the 3rd time for me, twice left, and now on right. The oncologist feels that each is new cancer, but when pressed, said there is no real way to know since cancer mutates so much. In June I noticed my right arm was swollen. And ultra sound at urgent care showed no blood clot and I was told to see my DR. It was odd, since the surgery had been on the left side. Eventually cancer diagnosed, and the thinking was that the cancer was the source of the lymphedema rather than prior treatment. I'm worried about the upcoming surgery, concerned that it will be much more complicated since it is in the axilla this time.
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. 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.
8/2019 CT, Breast/chest , neck/thyroid ultra sound
9/2019 DR ordered biopsy, said it could be lymphoma, cancer, benign lymphatic. Biopsy R-axilla. Cancer. Genetic test showed no known markers (20+ looked for)
9/29/2019 PET scan, no indication of spread. Arimadex and Ibrance prescribed to shrink tumor prior to surgery
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Cryoablation and Immunotherapy: An Enthralling Synergy to Confront the Tumors
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^^Thanks, BGRS, hope the info was useful!
Revamped cancer drug starves tumors in mice
A bacteria-derived compound called DON... kills tumors by inhibiting several enzymes that allow cancer cells to use glutamine. In clinical trials, however, the drug provoked severe nausea and vomiting, and it was never approved.
Now, Powell and colleagues have crafted a new version of DON that may be easier to stomach. It carries two chemical groups that keep it inert until it reaches the tumor's neighborhood. There, enzymes that normally loiter around tumors remove these molecular handcuffs, unleashing the drug on the cancerous cells. With this approach, "the vast majority of the active drug is where we want," Powell says.
To test their new compound, he and colleagues injected four types of cancer cells into mice, inducing tumors. They then dosed some of the animals with their next-generation DON. The drug worked against all four kinds of tumors, the scientists report today in Science. In untreated mice, for example, colon cancer tumors had grown more than five times larger after about 3 weeks. But in rodents that received DON, the tumors shrank and almost disappeared. The researchers found that the drug wasn't just throttling glutamine metabolism. It was also disrupting other aspects of the cells' biochemistry, such as their ability to use the sugar glucose.
One concern about drugs that target cancer cell metabolism is that they will also poison normal cells, including the immune cells that battle tumors. But Powell and colleagues found that their version of DON revved up T cells to destroy cancer cells. The scientists discovered that T cells deprived of glutamine by DON could switch to an alternative source of the raw materials needed to synthesize DNA and other key molecules, whereas tumor cells couldn't.
...Powell says safety testing of the drug will begin in people [next year].
Article: https://www.sciencemag.org/news/2019/11/revamped-cancer-drug-starves-tumors-mice
Paper (abstract is free): https://science.sciencemag.org/content/early/2019/11/06/science.aav2588
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Human trials to begin next year using a virus to kill cancer
Scientists have created a new cowpox-style virus in a bid to cure cancer.
The treatment, called CF33, can kill every type of cancer in a petrie dish and has shrunk tumours in mice, The Daily Telegraph reported.
US cancer expert Professor Yuman Fong is engineering the treatment, which is being developed by Australia biotech company Imugene.
They are hoping the treatment will be tested on breast cancer patients, among other cancer sufferers, next year.
More context at: https://www.frontpagelive.com/2019/11/09/the-new-cure-that-can-kill-every-type-of-cancer-the-story-of-science-viruses-hope-and-money/
Company webpage about this virus: https://www.imugene.com/oncolytic-virus
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Cowpox like virus to treat cancer? Amazing. Cowpox is what was initially used to vaccinate against smallpox. Jefferson saw this used in France, and introduced to to the US. Fortunately, the vaccine came a long ways since those days. With the elimination of smallpox world wide, the vaccine is no longer part of the usual vaccines. I wonder how this new treatment will work on those of us old enough to have gotten a smallpox vaccine as a child.
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Not sure, but a neighbor of mine with glioblastoma that recurred after chemo/radiation is going to be treated with the polio virus--so far this polio treatment has shown the most positive results for glioblastoma as there really are not a lot of good options for that particular cancer. He said he got the polio virus immunization as a child and he had to get some sort of booster and make sure he was responding to the booster before they proceed. . .in some ways this treatment sounds similar. Here is some info on the polio virus thing he is doing. . .
"The poliovirus receptor is present on all solid tumors, which means that all solid tumors will get infected by the genetically modified poliovirus if put in contact with it," she said. "Another positive is that the poliovirus survives for only a short period of time: It triggers the infection and the immune activation, but then disappears. It does not stay around and decrease the long term immune response like other viruses might do."
In May 2016, the Food and Drug Administration (FDA) granted breakthrough therapy designation to the genetically modified poliovirus, PVSRIPO, which will hopefully help expedite research into this line of therapy.
For this study, the phase 2 trial is ongoing in adults with recurrent glioblastoma and a phase 2 trial is open for pediatric patients with a recurrent brain tumor. Investigators plan to soon begin trials in patients with melanoma and breast cancer."0 -
I saw the same information about the cowpox virus, and posted in on the ringworm, etc. link for stage 4 cancer. It sounds very interesting.
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USFDA designates Indian invention a 'breakthrough device' for cancer
The Centre for Devices and Radiological Health (CDRH) of the US Food and Drug Administration (USFDA) has designated Cytotron—a device invented in India by a Bengaluru scientist—as a "Breakthrough Device" in the treatment of liver, pancreas and breast cancers...
Cytotron uses Fast Radio Bursts (FRB)—a high energy and powerful short radio bursts—in which both electric and magnetic components of the electromagnetic signals are "circularly" polarized...
FRBs can be used to communicate with the cellular command and control, to up or down regulate a specific protein or gene. In cancer cells, Cytotron does two things:First, it alters the protein pathways of a pro-apoptosis protein called p53 via p21 inducing programmed cell death in the cancer cells, and secondly, exposure to Cytotron stops metastasis by inhibiting the Epithelial Mesenchymal Transition cells, responsible for spread of cancer[.]
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"Scientists have created a new cowpox-style virus in a bid to cure cancer.
The treatment, called CF33, can kill every type of cancer in a petrie dish and has shrunk tumours in mice, The Daily Telegraph reported.
US cancer expert Professor Yuman Fong is engineering the treatment, which is being developed by Australia biotech company Imugene.
They are hoping the treatment will be tested on breast cancer patients, among other cancer sufferers, next year."
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Common early sign of cardiovascular disease also may indicate cancer risk, study finds
A Mayo Clinic-led study involving 488 cardiac patients whose cases were followed for up to 12 years finds that microvascular endothelial dysfunction, a common early sign of cardiovascular disease, is associated with a greater than twofold risk of cancer.
https://journals.sagepub.com/doi/full/10.1177/2047487319884246
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'Smart needle' could speed up cancer detection 'with a less intrusive process'
Cancer detection could become much quicker and easier in the future after scientists developed a new "smart needle" that uses a mini laser to identify diseased tissue within seconds.
Researchers have demonstrated the technique works in the lab and have just begun a major three-year clinical trial to test it in living people.
They have focused on lymphoma so far but are hopeful the technique could also be used to diagnose other forms of the disease, such as breast and prostate cancer, further down the line.
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NIH RO1 grant to help improve ultrasound tomography for breast cancer detection
"The current methods of mammography or tomosynthesis are based on X-rays," Anastasio noted. "Some small early stage cancers especially in younger women are difficult to detect in such images so the industry understands the need for improvement. We're investigating this new technology that can be useful for breast cancer imaging that is based on the use of ultrasound instead of X-rays. Not only is it safer because it doesn't involve ionizing radiation, it is more sensitive to certain tissue properties that will make it easier to detect subtle breast cancers..."
"We quickly realized that through the use of advanced image reconstruction principles and high-performance computing, we can actually do a better job of modeling the physics and reconstruct images of much better quality," Anastasio explained. "They almost look like MRI images in terms of resolution."
Both Duric and Anastasio chose to focus this technique on breast cancer detection, partly because it is a disease the affects a vast number of women, but also because it is a part of the body where ultrasound tomography will work relatively well.
https://www.eurekalert.org/pub_releases/2019-11/uoic-nrg111119.php
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Axillary Evaluation Is Not Warranted in Patients Preoperatively Diagnosed With DCIS Core Needle Biopsy
- The authors of this retrospective study of 604 women with a preoperative diagnosis of ductal carcinoma in situ (DCIS) by core needle biopsy looked for predictors of upstaging and axillary lymph node metastasis. Upstaging to DCIS with microinvasion (20%) and invasive breast cancer (32%) was common, but positive axillary lymph nodes (7%) were not. Factors predicting upstaging on multivariate analysis included tumor size >2 cm on ultrasound and ER+/HER2+ status. Factors predictive of axillary lymph node metastasis included tumor size on pathology and number of lesions.
- The authors concluded that the finding of a low rate of axillary metastasis, even in the setting of a 52% upstaging rate in this study, supports the omission of axillary evaluation in low-risk patients.
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