Breaking Research News from sources other than Breastcancer.org
Comments
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May favorite prof in college taught Anthropology, so I took lots of anthro. We covered a South American indigenous tribe for a good year. (Thanks for the trip down memory lane.) Then I did a lot of maternal-child nursing. So I get the spaced pregnancies and kinship groups from both perspectives. (We clearly need more hands on deck!) And you are right: the intentionally anxiety-producing, relentless news cycles do nothing for our health!
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I like the grandmother effect explained. It corresponds with what I read about native Americans culture with sisters, aunts, mothers and grandmothers. So many kids move away, have 2 income households and are in daycare, before care, after care. It's often good quality care but it's still not the same family they are around nights, weekends, ,etc. It's also reassuring that menopause is not natures way of saying "you've served your purpose - be gone".
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Indeed, I think of it more like: "Hey you, with the experience and skills and patience: you are needed to help launch a baby!"
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Interesting chat. Takes a village to raise a child
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Interesting article on chemotherapy causing an immune suppression and the risk of ARDS which is what normally causes death in Covid19 patients. Actually, if I'm reading this correctly, it's good news for the immune suppressed group.
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Jessie, this is fascinating and surely counter-intuitive! I read the article, and this could be my husband and I, though we're in our 70s rather than 60s. I was on fulvestrant and abemaciclib (Ibrance and Faslodex) for 23 mo before being switched to Xeloda. My husband and I have assumed that I am the more at risk of the two of us, but based on this article, it may be the reverse. The "cytokine storm" affect, which appears to be the cause of death in many Covid-19 cases, is lessened in this example because the woman is immunosuppressed whereas her husband is not, and it is he who suffers its affects. Thank you for posting this. I have sent it to my infectious disease professor/guru for his perusal!
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The 10th Annual National Conference on Work & Cancer has gone virtual! This free, full-day online conference is open to patients, survivors, caregivers, healthcare/HR professionals* and anyone else touched by cancer. Stay tuned for the finalized agenda.
Cancer and Careers
Friday, June 19, 2020
8:45 AM - 5:00 PM Eastern TimeThe 10th-year anniversary of our National Conference on Work & Cancer will be held virtually on Friday, June 19, 2020!
This free, online daylong conference explores the complexities of balancing treatment and recovery with employment and is open to patients, survivors, caregivers, healthcare professionals, employers/HR professionals and anyone else touched by cancer.
Complimentary CEUs/PDCs are available for nurses, social workers and HR professionals. For more information on accreditation, click here.
Note: This event was previously scheduled to be held at the CUNY Graduate Center in NYC. Due to COVID-19, the National Conference will be hosted virtually instead.
Date:
Friday, June 19, 2020
Time:
8:45 AM-5:00 PM
Please log/dial in 10-15 minutes priorLocation:
Online
Webinar & phone options available
Login and dial-in info will be emailed to registrantshttps://www.cancerandcareers.org/en/community/even...
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Joy -- I know --- it really is good news for those who are immunosuppressed. I have been thinking a lot about the people in that category and the people going through treatment now. I was hoping this article would relieve some of the additional stress. So glad it helped you -- will you let us know what your infectious disease professor says? I know two young people who have had ARDS -- one from the flu and the other from pancreatitis. Both were young with very strong immune systems.
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I'm walking with the guru's wife this AM and will find out what he had to say. He's busy doing webinars almost every day on the coronavirus.
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FDA approves pill for aggressive breast cancer that's spread in the body
Another article re Tucatinib. Easy to read. Includes OS and cost numbers.
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Staying at One's Job to Maintain Employer-Based Health Insurance Among Cancer Survivors and Their Spouses/Partners
Many cancer survivors experience challenges related to employment, including limitations in ability to work. Given that most health insurance coverage for working-age individuals in the US is employer-based, a challenge is the inability to freely leave a job given limitations on health insurance portability, also called job lock. Job lock can negatively affect career trajectory and quality of life. Likewise, spouse/partner job lock can also affect family well-being. We examined job lock prevalence among cancer survivors and their spouses/partners and associated factors in the US.In this study, approximately 1 in 3 cancer survivors in the US reported job lock for themselves or their spouses/partners, suggesting that job lock is common and has implications for the well-being and careers of both survivors and their families. Given higher prevalence of job lock among younger survivors and those with incomes near the poverty level, it is important to note that those earning between 138% and 400% of the FPL are ineligible for Medicaid and may have fewer employment alternatives with comprehensive health benefits. Clinicians, social workers, and navigators have opportunities to identify job lock and other employment concerns throughout treatment/survivorship care and connect survivors with employment and health insurance counseling.Kent EE, de Moor JS, Zhao J, Ekwueme DU, Han X, Yabroff KR. Staying at One's Job to Maintain Employer-Based Health Insurance Among Cancer Survivors and Their Spouses/Partners. JAMA Oncol. Published online April 23, 2020. doi:10.1001/jamaoncol.2020.07420 -
Fight or Flight: Does Stress Make Radiation Therapy Less Effective?
— Suppressing beta-receptor signaling enhanced tumor control in preclinical study
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mysticalcity - that is fascinating. So possibly the women who experience the most stress from the process of radiation also get the least benefit. ARGH but also so glad they are studying this.
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Triple negative breast cancer might not actually be 'breast cancer'
....Researchers have discovered...that the molecular mechanisms involved are more closely related to non-breast cancers, and two specific gene mutations may be responsible for the tumor development.
The research team found the presence of a mutated p53 (a tumor suppressor gene whose mutation often leads to cancer development) and a mutated PARP (a gene that maintains DNA integrity) in a large majority of patients with triple negative breast cancer. Specifically, they found that p53 would interact with replicating DNA and PARP, driving cell growth and division.
"Our new findings suggest that the presence of both [p53] and PARP could serve as a good identifier of breast cancers that would respond to combined treatment with talazoparib — a PARP inhibitor that was developed to treat breast cancers with the BRCA mutation — and temozolomide — a chemotherapy agent that is used to treat some brain cancers," said Professor Jill Bargonetti, whose lab conducted the research. "This is an exciting finding because it could lead to the first targeted therapy for triple negative breast cancer, enabling more precise and effective treatment of a very aggressive form of the disease."
...this group plans to test if this combination of drugs can successfully block replication of triple negative breast cancer cells in xenographed animal models. If the therapy can prove to be successful, it would very likely lead to the reclassification of triple negative breast cancer to a category of cancers called mutant p53/PARP1 positive cancers, which are treatable with a combination PARP inhibitor therapies.
This study gives doctors two new biomarkers to test for in patients, and many new potentials in clinical trials, which can be fast tracked since so many drugs already exist that target these specific genes. While this study only tested out two drugs, there are many other drugs that specifically target p53 and PARP, and many more which can be developed, which may give even better results. Hopefully, there will be many new, positive developments for this disease following this discovery.
https://www.clinicalomics.com/topics/precision-med...
https://cancerres.aacrjournals.org/content/early/2...
DOI: 10.1158/0008-5472.CAN-19-1036
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that's very exciting news
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It is exciting. And p53 and PARP mutations are pretty common among other types of breast cancer. So maybe the research may lead to new tools for treating other sub-types, too.
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A couple of days ago I stumbled on a piece of research that might have been linked here before, as it came out in July 2019. But I hadn't seen it and thought it was exciting news about recurrence risk for TNBC. TNBC has a relatively high recurrence risk (in the past week I've seen research numbers such as 22%, 25%, and 42%, so who knows what the real figure is. Regardless, it's high.) Since we don't know which patients will recur and which won't, almost all of them go through the whole range of treatment, including chemo. If we could identify the patients least likely to recur, they could perhaps be spared some of the more aggressive treatment. Here is the abstract and link.
"Approximately 40% of patients with stage I–III triple-negative breast cancer (TNBC) recur after standard treatment, whereas the remaining 60% experience long-term disease-free survival (DFS). There are currently no clinical tests to assess the risk of recurrence in TNBC patients. We previously determined that TNBC patients with MHC class II (MHCII) pathway expression in their tumors experienced significantly longer DFS. To translate this discovery into a clinical test, we developed an MHCII Immune Activation assay, which measures expression of 36 genes using NanoString technology. Preanalytical testing confirmed that the assay is accurate and reproducible in formalin-fixed paraffin-embedded (FFPE) tumor specimens. The assay measurements were concordant with RNA-seq, MHCII protein expression, and tumor-infiltrating lymphocyte counts. In a training set of 44 primary TNBC tumors, the MHCII Immune Activation Score was significantly associated with longer DFS (HR = 0.17; P = 0.015). In an independent validation cohort of 56 primary FFPE TNBC tumors, the Immune Activation Score was significantly associated with longer DFS (HR = 0.19; P = 0.011) independent of clinical stage. An Immune Activation Score threshold for identifying patients with very low risk of relapse in the training set provided 100% specificity in the validation cohort. The assay format enables adoption as a standardized clinical prognostic test for identifying TNBC patients with a low risk of recurrence. Correlative data support future studies to determine if the assay can identify patients in whom chemotherapy can be safely deescalated and patients likely to respond to immunotherapy.
Significance: The MHCII Immune Activation assay identifies TNBC patients with a low risk of recurrence, addressing a critical need for prognostic biomarker tests that enable precision medicine for TNBC patients."
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Adjuvant Chemotherapy Associated With Early, But Not Sustained, Cognitive Impairment in Women With Early-Stage Breast Cancer
he
addition of chemotherapy to endocrine therapy in the treatment of early-stage
hormone receptor-positive, HER2-negative breast cancer was associated with a
significant increase in the level of perceived cognitive impairment, according
to results of the TAILORx trial published in the Journal of Clinical Oncology.At the 3-month assessment, 36.7% and 26.3% of
patients treated with and without chemotherapy vs no reported cognitive
impairment. While a
significant difference in patient-reported cognitive impairment was also
observed when these respective groups were compared at 6 months, it was no longer seen at 12
months and beyond....neither patient age nor menopausal status was associated with changes in perceived cognitive impairment.
https://www.oncologynurseadvisor.com/home/cancer-t...
Wagner LI, Gray RJ, Sparano JA, et al. Patient-reported cognitive impairment among women with early breast cancer randomly assigned to endocrine therapy alone versus chemoendocrine therapy: results from TAILORx [published April 9, 2020]. J Clin Oncol. doi: 10.1200/JCO.19.01866
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cfDNA Test May Detect Disease Among Patients Who Are Suspected of Having Cancer
A plasma cfDNA test was able to detect cancer in patients who had a high suspicion of cancer, and was able to predict tissue of origin among patients with confirmed cancer, according to results presented at the American Association for Cancer Research (AACR) Virtual Annual Meeting I 2020.
In the overall substudy 2 cohort, the cfDNA test had 99.8% and 99.3% specificity for detecting cancer in training and validation, respectively. In the HCS subgroup from substudy 2, the specificity increased to 100% for both training and validation.
https://www.cancertherapyadvisor.com/home/cancer-t...
Thiel DD, Chen X, Kurtzman KN, et al. Prediction of cancer and tissue of origin in individuals with suspicion of cancer using a cell-free DNA multi-cancer early detection test. Presented at: American Association for Cancer Research (AACR) Virtual Annual Meeting I; April 27-28, 2020. Abstract CT021.
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Meet My Loved One: Making palliative connections in times of isolation
...she wrote down all the little personal details she would have told the nurses and staff as if she were there in person. The fact that he liked to watch "Animal Planet." His love of ice cream, and his distaste for rice. His preference for cold drinks that felt better when he swallowed. And that no one needed to make him wear his oxygen if the canula made him uncomfortable. She emailed it to her dad's social worker and asked that it be taped on the wall.
The effort, and the health care team's response, brought her some peace of mind.
"It's the little things that mean so much," {his daughter} Harding said.
https://www.uab.edu/medicine/palliativecare/patient-care/covid-19-resources
{Not therapeutic research but I thought this might be helpful to someone.}
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Congress must tackle patient matching amid COVID-19, says Pew Charitable Trusts
Persistent flaws in the ability to accurately ID and match patient records are hindering two must-haves on the road to reopening: contact tracing and, eventually, vaccine administration.
Detailed contact tracing in the short term and a nationwide vaccination program in the long term "hinge on having correct patient demographic data," according to the letter, but "current flaws in the identification and matching of patient records inhibit the nation's ability to accomplish these efforts successfully."
The need for better patient matching is a drum that Pew has been beating for a long time....
{An interesting is slightly wonky, discussion of a current public health issue.}
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Lumpie - love the article about the Dad in palliative care and what his daughter wrote to post by his bedside. Great ideas. Something we should all pay attention to even when there is no virus.
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Killing 'sleeper cells' may enhance breast cancer therapy
The research, which used breast cancer cells taken from patients, was the first to show that venetoclax could kill sleeping, or "senescent," cancer cells.
The promising preclinical results for this "triple therapy" have underpinned a phase 1 clinical trial in Melbourne that is combining venetoclax with hormone therapy and CDK4/6 inhibitors in patients with ER+ breast cancer.
https://medicalxpress.com/news/2020-05-sleeper-cells-breast-cancer-therapy.html
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Hypofractionated Breast Radiotherapy for 1 Week Noninferior to 3 Weeks
- The authors report the 5-year efficacy data from a phase III trial designed to compare hypofractionated breast radiotherapy for 1 week versus 3 weeks for localized breast cancer. A radiotherapy schedule of 26 Gy in 5 fractions over 1 week was found to be noninferior to 40 Gy in 15 fractions over 3 weeks in terms of local tumor control. In addition, the 1-week schedule had similar tissue effects at 5 years compared with the 3-week schedule.
- Patients prescribed adjuvant local radiotherapy following primary surgery for early-stage breast cancer may consider a 1-week hypofractionated radiotherapy schedule.
DOI:https://doi.org/10.1016/S0140-6736(20)30932-6
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Quality-of-Life Outcomes in Surgical vs Nonsurgical Treatment of Breast Cancer–Related Lymphedema
- The authors of this systemic review found that health-related quality-of-life outcomes in patients with breast cancer–related lymphedema were associated with improvement following treatment with vascularized lymph node transfer in 2 studies. However, complex decongestive therapy studied in 14 trials had variable associations, and diverse outcome measures and varied protocols limited interpretation.
- Additional studies comparing outcomes with surgical and nonsurgical management of breast cancer–related lymphedema are needed.
doi:10.1001/jamasurg.2020.02300 -
Prediagnostic serum selenium levels in relation to breast cancer survival and tumor characteristics
...The Malmö Diet and Cancer Study, a population‐based cohort study of 17,035 women recruited between 1991 and 1996, was used for breast cancer cases and controls. After exclusion, they assessed 1,066 cases. Among breast cancer free women, they selected controls both from matching (n = 694) as well as randomization (n = 492). Analysis revealed no correlation between serum Se quartile and any tumor characteristic or intrinsic subtype. Women in the highest Se quartile had lower overall mortality than those in the lowest. They identified similar results for breast cancer‐specific mortality. Findings thereby support the association of Se with a lower mortality in breast cancer.
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Cancer screenings drop upward of 94% during pandemic, with concerns of lingering sluggishness
Routine cancer screenings have dropped precipitously during the COVID-19 pandemic's initial spread, a trend that has experts concerned about an explosion in more severe diagnoses in the coming months.
Epic recently made this discovering after analyzing data from about 2.7 million patients, treated at 190 hospitals across 23 states. The electronic health record vendor specifically targeted cervical, colon and breast cancer, and found a roughly 86%-94% drop in screening levels when compared to previous care volumes logged between 2017-2019.
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While I'm sure there are people who felt safer to skip, I know a lot of my friends had their Mammos canceled by the facility, they weren't happy
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I'm an ICU nurse. I know I need an end-of-life directive. So why can't I bring myself to write it?
{Not research but one of the best articles I have found on issues surrounding advanced directives. We all know, at some level, that we need them but the cookie-cutter approach just does not seem to fit. So we do nothing.}
https://www.washingtonpost.com/health/im-an-icu-nu...
{Wa Po may allow access to a limited number of articles per month without subscription.}
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