Breaking Research News from sources other than Breastcancer.org
Comments
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Notre Dame Developing 'Grain of Rice'-Size Breast Cancer Sensor
[Marker clips being designed that actively analyse breast cancer tumors.]
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Pre-diagnostic 25-hydroxyvitamin D concentrations in relation to tumor molecular alterations and risk of breast cancer recurrence
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My BS swears low Vit D levels are a huge contributor to BC. He's done an unofficial study of just his patients and finds this consistently. My levels were 28 when I diagnosed. I now run about 82 so here's hoping that's keeping BC away!
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i read a study (when I was first diagnosed) done in Ireland and they believed Low Vitamin D played a role in Breast Cancer and well.
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My level was 10 when I left a sunny state for a rainy state! I have several doctors that check my D level which is now in the 50s. It really jumped when I switched to a brand with flax oil. And yet one doctor I got by default and head of a big department said to me that they don’t regularly test for vitamin D! I left her in my rearview mirror after two visits.
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I'm glad that they are looking at this more closely but just want to push back a little and say that all of this is still in correlation phase rather than causation here. Even if lower vitamin D were associated with breast cancer, it doesn't by any stretch mean that increasing vitamin d levels would reduce the rate.
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Statins Appear to Protect the Heart Against Breast Cancer Treatment Toxicities
https://www.cancerhealth.com/article/statins-appear-protect-heart-breast-cancer-treatment-toxicities
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Hepatic Resection for Breast Cancer Liver Metastases
- European Journal of Surgical Oncology April 02, 2020
- In this matched cohort study, the authors compared outcomes of patients with breast cancer liver metastases who received either systemic therapy alone (n = 763) or in addition to hepatectomy (n = 136). After propensity score matching, the 5-year overall survival rate was superior in the surgical group (56% vs 40%; P=.018). Among patients undergoing hepatectomy, the median overall survival was longer among patients with luminal B and HER2-enriched subtypes compared with luminal A and basal-like subtypes, and progression-free survival was significantly longer among patients with the HER2-enriched subtype compared with others.
- The authors concluded that these findings support the incorporation of surgery into appropriately selected patients with isolated breast cancer liver metastases.
- Conclusion:
Surgical resection of BCLM yielded higher OS compared with systemic
therapy alone and prolonged PFS among patients with the HER2-enriched
subtype. These findings support the use of surgical therapy in
appropriately selected patients, based on intrinsic subtypes.
- Commentary by Lillie D Shockney RN, BS, MAS, ONN-CG
This enlightening information needs to get into the hands of breast cancer tumor boards and surgical oncologists everywhere. It is common for a patient to only be in the hands of medical oncologists and occasionally also radiation oncologists once diagnosed with stage IV breast cancer. Note that I did not say "breast surgical oncologists" but instead "surgical oncologists" because the surgeons doing this type of procedure need to be the hepatobiliary surgical team members.
Identifying liver metastases when they are isolated and small becomes more important now. Trying to surgically remove multiple lesions of various sizes and in various locations within the liver usually isn't recommended, but one or two isolated lesions usually can be successfully excised and the recovery can be fairly quick, too.
https://www.practiceupdate.com/C/98424/56?elsca1=e...
https://www.ejso.com/article/S0748-7983(20)30373-5/fulltext
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https://www.swissinfo.ch/eng/medical-innovation_sw...
Smart bra to detect breast cancer. This would probably work as a back up system. I'll have to ask the company if this takes mastectomies into consideration.
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Lumpie,
Thanks for posting the report on resection of liver metastases. I saw that a few days ago and sent it to my MO. She was resistant when I wanted to do a microwave ablation of my largest liver lesion last summer, wanting to go into systemic treatment immediately instead. But it seems to have helped me, and this article is very helpful for others.
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And I'm saving it for when I have future progression from bones to liver. Thank you!
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I had a partial liver resection in 2015 for a solitary liver met. I have been very happy with that choice.
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Thanks Lumpie for posting the study of hepatic resection for breast cancer mets. I had a liver resection for one liver met in June 2019. I have not regretted that decision, even though I now have more liver mets. The area that was resected has no evidence of disease. For people having a liver resection, I'd advise being aggressive about preventing constipation.
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Sounds like several have had resection or ablation. They attempted ablation of my lesions in 2019. Were not able to complete due to proximity of lesions to colon. Bummer. I really wish we could have gotten rid of the only ones visible at the time. They had to incise me and attempt it before figuring out that it was not feasible. Mine was an out patient procedure with a tiny incision. In my experience, there was virtually no recovery. When it goes well, it is far less expensive than chemo and may result in fewer side effects. It seems that the improved outcomes are becoming better documented all the time. If this continues to be the case, it may be a more frequently used therapy for suitable candidates.
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High fibre diet linked to lower breast cancer risk
Consuming a diet high in fibre is linked with a reducing in incidence of breast cancer, according to a random‐effects meta‐analysis published in the journal CANCER.
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Immunomedics' Triple-Negative Breast Cancer Trial Halted Early Due to Compelling Efficacy
Positive results for clinical trial of sacituzumab govitecan for TNBC
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The Development of CDK4/6 Inhibitors
For those who appreciate webinars, NBCC is "sharing a very special President's Council webinar conducted by a hero in the breast cancer community, Dr. Dennis Slamon, professor of medicine, chief of the Division of Hematology/Oncology and executive vice chair for research for UCLA's Department of Medicine, and the 2019 Lasker Award winner.
In this 45-minute webinar recording Dr. Slamon discusses, in very accessible language, the development of and the science behind CDK-4/6 inhibitors, a class of drugs that interrupt tumor cell proliferation.
We hope you enjoy this outstanding discussion about one of the most important therapeutic discoveries in the field of breast cancer since the development of Herceptin."
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Association between early informed diagnosis and survival time in patients with lung cancer
Background: As a malignant tumor with high mortality, lung cancer (LC) often causes great trauma to patients, and a series of negative emotions and a heavy psychological burden accompanies poor prognosis. Whether or not to inform the patients of their condition has always been a controversial topic in the medical community. This retrospective cohort study investigated the association between early informed diagnosis and survival time in patients with LC.
Methods: A total of 29 825 patients with LC were enrolled between October 2002 and December 2016. The potential factors influencing LC survival were registered, including knowing their cancer diagnosis status, age, gender, pathological type, clinical stage, surgical history, hospital grade, and patient occupation. All participants were followed up every 6 months until June 2017.
Conclusions: Knowing their cancer diagnosis contributed to longer survival time in patients with LC, providing clear evidence that medical staff and patients' families should fully disclose cancer diagnoses to patients.
Funding information: National Science Foundation of China, Grant/Award Number: 81602734; National Social Science Fund of China, Grant/Award Number: 17ZDA327
https://onlinelibrary.wiley.com/doi/10.1002/pon.53...
https://onlinelibrary.wiley.com/doi/full/10.1002/p...
https://doi.org/10.1002/pon.5360
{Note: This research was done in China. In contrast to western practices, it has not always been the custom there to inform patients of their diagnosis.}
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Immunomedics Announces ASCENT Study to be Stopped for Compelling Efficacy
A phase III clinical trial of the antibody-drug conjugate sacituzumab govitecan in triple-negative breast cancer stopped early because of "compelling efficacy across multiple study endpoints,"
"Triple-negative breast cancer (TNBC) is a disease with extremely limited treatment options beyond classic chemotherapy. The remarkable results we observed across multiple endpoints in the ASCENT study warranted early discontinuation of the trial and are indicative of a potential major advance in the treatment of this devastating disease that affects younger women and African American women at higher rates. I look forward to the release of the full and final analyses of these study data when they are available for public presentation."
ASCENT is a Phase 3 confirmatory study designed to validate the promising safety and efficacy data of sacituzumab govitecan observed in a Phase 2 study of heavily pretreated patients with metastatic TNBC (mTNBC). The primary endpoint for the study is progression-free survival, and secondary endpoints include overall survival and objective response rate, among others.
The Company hosted a conference call on April 6, 2020, to provide a clinical development and general corporate update. a webcast replay of the conference call will be available on the Company's website for approximately 30 days. at https://immunomedics.com/investors/.
https://www.immunomedics.com/our-company/news-and-...
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Cancer Research UK, which funds about half of all cancer research in England, announced a £44 million ($54 million) cut in research support as a result of fundraising shortfalls.
https://www.cancerresearchuk.org/funding-for-resea...
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Differences in Stage of Cancer at Diagnosis, Treatment, and Survival by Race and Ethnicity Among Leading Cancer Types
Question Do stage of cancer at diagnosis, use of definitive therapy, and survival differ by race/ethnicity among patients with 1 of the most common cancers?
Findings In this cohort study of 950 377 patients with cancer, stage at diagnosis, treatment, and survival varied by race and ethnicity. Overall, compared with Asian patients, black patients were more likely to have metastatic disease at diagnosis, black and Hispanic patients were less likely to receive definitive treatment, and white, black, and Hispanic patients had worse odds of cancer-specific and overall survival.
Meaning The findings of this study may lead to different management strategies based on race and ethnicity to improve outcomes.
https://www.upi.com/Health_News/2020/04/08/Black-p...
https://jamanetwork.com/journals/jamanetworkopen/f...
doi:10.1001/jamanetworkopen.2020.2950
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Revolutionary Machine Learning Company Identifies Two Possible Treatments for Intractable Breast Cancer Type
The two therapy treatments successfully completed final in vitro organoid testing at Lawrence Berkeley National Laboratory, demonstrating "significant synergistic interaction" in killing malignant tumor cells, with statistically "low-to-no adverse effects" on healthy cells. With these results, Pattern Computer will proceed to the next phase of preclinical testing.
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Seattle Genetics Announces U.S. FDA Approval of TUKYSA™ (tucatinib) for People with Advanced Unresectable or Metastatic HER2-Positive Breast Cancer
04/17/2020
-Approved for Patients with HER2-Positive Metastatic Breast Cancer Who Have Received One or More Prior Anti-HER2 Therapies in the Metastatic Setting-
-First HER-2 Tyrosine Kinase Inhibitor in Combination to Improve Overall and Progression-Free Survival in Patients with Metastatic HER2-Positive Breast Cancer With or Without Brain Metastases-
-Application Approved Four Months Prior to Action Date Under FDA's Real-Time Oncology Review (RTOR)-
BOTHELL, Wash.--(BUSINESS WIRE)-- Seattle Genetics, Inc. (Nasdaq:SGEN) today announced the U.S. Food and Drug Administration (FDA) granted approval to TUKYSA™ (tucatinib) tablets in combination with trastuzumab and capecitabine for adult patients with advanced unresectable (cannot be surgically removed) or metastatic HER2-positive breast cancer, including patients with brain metastases (disease that has spread to the brain), who have received one or more prior anti-HER2-based regimens in the metastatic setting. The FDA previously granted Breakthrough Therapy designation and Priority Review for TUKYSA and reviewed this application for approval under the Real-Time Oncology Review (RTOR) pilot program. The TUKYSA New Drug Application (NDA) is also part of Project Orbis, an initiative of the FDA Oncology Center of Excellence that provides a framework for concurrent submission and review of oncology drugs among participating international health authorities. TUKYSA is an oral, small molecule tyrosine kinase inhibitor (TKI) of HER2, a protein that contributes to cancer cell growth.
https://investor.seattlegenetics.com/press-release...
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Urban vs. rural residence and outcomes in older breast cancer patients
Kelly M Kenzik, Gabrielle B Rocque, Wendy Landier and Smita BhatiaDOI: 10.1158/1055-9965.EPI-19-1414Abstract
Background: 20% of the US population resides in rural areas, yet is served by 3% of oncologists, and 7% of non-oncology specialists. Access to care issues can be compounded by lower socioeconomic status (SES) in rural areas, yet this issue is unexplored among older patients with breast cancer. Methods: Using SEER-Medicare, 109,608 patients diagnosed at ≥65y with breast cancer between 2000 and 2011 were identified. Residence status was combined with Federal Poverty levels: urban (high-, medium- and low-poverty); rural (high-, medium- and low-poverty). Five-year overall survival (OS) and healthcare utilization (HCU: visits to primary care provider [PCP], oncologist, non-oncology specialist, emergency department) were examined using urban/low-poverty as reference. The residence, HCU, mortality association was examined using mediation and moderation analyses. Results: Median age was 76y; 12.5% were rural, 15.6% high-poverty. 5y OS: 5y OS was 69.8% for rural and 70.9% for urban. Both urban- and rural/high-poverty patients had a 1.2-fold increased mortality hazard. Rural/high-poverty patients had a higher rate of PCP (Y1: IRR=1.23; Y2-Y5: IRR=1.19) and ED visits (Y1: IRR=1.82; Y2-Y5: IRR=1.43), but lower non-oncology specialist visit rates (Y1: IRR=0.74; Y2-Y5: IRR=0.71). Paucity of non-oncology specialist visits mediated 23%-57% of excess mortality risk. The interaction between residence/SES and paucity of non-oncology specialist visits accounted for 49%-92% of excess mortality risk experienced by rural/high-poverty patients vs. urban/low-poverty. Conclusions: Urban-rural residence mortality differences among older breast cancer patients are highly predicated by poverty level. Impact: Rural/high-poverty patients demonstrate less use of non-oncology specialists compared to urban/low-poverty, with disparities moderated by specialist use.
- Received November 12, 2019.
- Revision received February 12, 2020.
- Accepted April 10, 2020.
- Copyright ©2020, American Association for Cancer Research.
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Paucity of non-oncology specialist visits mediated 23%-57% of excess mortality risk
Wait, does this mean that since they were not properly treated for other issues they died from those things instead of from cancer, and that's why their risk was mitigated??
For-profit medicine is killing us
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Salamandra: yeah... Upon reviewing the article, I think the take away is "it is better to be rich and healthy than to be sick and poor" which was one of my grandfather's favorite "philosogisms." I think that lack of access to care is killing plenty of people. Much of the state of health care is mind-boggling. I read these reports of how life expectancy has not improved in decades... with a slight exception for herceptin... it's demoralizing... but then I think that there is no doubt in my mind - and plenty of clinical evidence - that available meds have kept me alive longer and with better QOL... so is there something killing off others faster so that they are offsetting my gains? The improved screening which started in the late 20th century was supposed to improve outcomes. So how the heck did unimproved outcomes happen and what can we do about it?
And then there is the problem of for-profit medicine. I'm not sure.... is it killing us or "just" making us bankrupt (literally... and figuratively)? And does that really help anyone? This one we definitely need to do something about.
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Lumpie I think many bad health practices are on the rise, and so is childhood trauma-- things like this make for worse health outcomes society-wide, offsetting other gains. There is so much more obesity, depression, and anxiety than when I was a kid. Mental health struggles impact physical health a lot -- from the surging cortisol itself to the poorer self care practices which depressed people can have.
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santabarbarian: Too true. Sadly, many aspects of health seem to have deteriorated. It is interesting, or perhaps I should say telling, that as we see financial security and aspects of the social fabric, including kinship ties, deteriorate, we see a deterioration of physical health. Of course, there is a greater recognition and acknowledgement of mental health challenges today than there was in the past but we can't ignore that our (post?) modern society does seem to have a troubling effect on mental health.
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Just processing the speed, the change in a 24/7 news day is far more stressful mentally than a cave-human would ever be expected to deal with. The way stress responses are supposed to work is a cortisol surge that then drops away when you are safe. the kids of dangers and stresses we have now do not RESOLVE and so that becomes a toxic level of stress.
We have a "grandmother effect" -- human menopause is evidence that nature wanted more hands on deck to care for babies. So, lost kinship ties WOULD likely have a negative impact on child health.
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PS read Dr Bruce Perry on tribal man. In a hunter gatherer tribe you'd have about 40 people, all of whom you knew INTIMATELY. If you were a baby you'd never be put down but rather carried by mom or elder sibling.... There would be a ratio of 4 adults to every kid under 6. So there was much better adult modeling/ time spent with adults and a more body-contact kind of upbringing. I can imagine a lot of anxiety is alleviated by the presence of trusted adults all the time.
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