Breaking Research News from sources other than Breastcancer.org
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Olma, Great research and discussion!
And thanks, Santa Barbarian, I had heard about that and will try the hyperbaric oxygen therapy.
Blessings
Esther
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Glad you ladies have found value in this discussion. Thanks to Alabama Dee also for starting it off.
Snow-drop, thanks for that input! And yes, it is interesting how all the different oligotrials have different design.
I am really, really thankful to my MO for thinking outside the box and referring me for rads on my spine, seeing how these researchers think there is not really evidence for it o someone like me
As she said, it's practicing the art of medicine, rather than being too strict about the science.
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olma- I found that video very VERY interesting. Thanks for posting it. Both DRs said systemic first to see if it was truly oligo.This validates my treatment. Even though they seem to have de novo as the focus, I heard some reoccurrence discussion too. Mine came back 5 years after original treatment.
My MDACC surgeon said no until I had a systemic working at least stable disease and preferably some shrinkage. if I had the whole right liver lobe removed, the regenerative and healing process without any systemic could cause the probable micromets to explode and the surgery would have been more harmful than good. The video talked about risk/benefit like this.
HOWEVER, MDACC offered me an in-house random clinical trial on SBRT vs systemic. That did not track with their talk on the video. I declined because I wanted to still go for surgery at that time and I did not want to take the risk of micromets growing with no systemic.ALSO, I also had 2 blood biopsies while on treatment at MDACC with 0 result and the tumors were growing/ multiplying. That science needs some more time to improve like they said in the video.
They only hinted at using local therapy to slow down progression and give longer lifespan and better quality of life. No one mentioned local therapy on oligo to reduce tumor burden (that’s what I did with y-90)
I hope this area of treating oligo aggressively for curative intent and what that really means, gets more traction.
Both DRs insisted that more research is needed (ie clinical trials) to gather statistics. Meanwhile I’m glad some of our docs agreed to think outside the box and get us some local therapy that seems to be helping us. Anecdotal data here on this site is how I have educated myself and pushed for local treatments
Dee
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gals, gals, FINALLY something about polymetastatic disease!!!
This was a pre-phase 1 trial of what I think is mapping out essentially SABR dose escalation for polymetastatic disease
www.advancesradonc.org/article/S2452-1094(21)00092-0/fulltext
(trying url again. if I make it clickable it doesn't work so you're going to have to cut/paste)
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(xposted to mTNBC thread(
Keynote 355 Phase 3 clinical trial reports: IMPROVED OS with pembrolizumab (Keytruda) for mTNBC w. PD-L1 >10
details re OS to come at a medical meeting so we don't know how big an effect it has but it reached statistical significance & was clinically meaningful.
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Good one, moth! Thank
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one for early stage high risk TNBC
FDA approves pembrolizumab for pts with high-risk early stage TNBC based on DFS improvement seen in KN-522
https://www.merck.com/news/fda-approves-keytruda-p...
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Duration of Adjuvant Aromatase-Inhibitor Therapy in Postmenopausal Breast Cancer https://www.nejm.org/doi/full/10.1056/NEJMoa2104162
CONCLUSIONS: In postmenopausal women with hormone-receptor–positive breast cancer who had received 5 years of adjuvant endocrine therapy, extending hormone therapy by 5 years provided no benefit over a 2-year extension but was associated with a greater risk of bone fracture.
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Lilyishere- I saw that one and thought it was quite interesting. I lasted 4 1/2 years on the AI’s just couldn’t take the SEs anymore. Became metastatic a year later
Here is another summary report of er targeting trials
Dee
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Researchers Identify Biomarker to Predict Immunotherapy Response in Patients With Breast Cancer
The Major Histocompatibility Complex Class II protein has potential to predict immunotherapy benefit in two types of breast cancer.
Needs large Phase 3 trial to confirm
https://www.curetoday.com/view/researchers-identif...
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Has anyone here with ER PR + stopped taking the drug Arimidex after 7 years? If so what was your node involvement? Two years ago my MO told me about thise study https://www.breastcancer.org/research-news/5-more-years-of-ais-no-better-than-2-more so we agreed to go two more years making it 7 years of medication. December will be 7 years. The conversation we had on Monday at my 6 month appt was that she wanted me to get a bone density scan and that would determine if we kept going on the arimidex. If I had issues, we would stop it was my guess since it eats at your bones.
I get a call today that I have Osteopenia. I talked to the PA and she said my doctor wants me to go another 3 years on the arimidex and take the Prolia shot every 6 months! I've always been told that with grade 1 I had a cancer that was not aggressive and chemo was an "insurance policy". Now the PA is telling me I am at more high risk because I had node involvement and the 7 years is for people who have no node involvement. My MO has never told me this in the conversations we had about stopping the medication. I'm not sure what I want to do to be honest. I'm disappointed because I was ready to stop with the meds that have my hair thinning, the fat is harder to lose and my vajay jayay is a desert!
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HomeMome, I think it's reasonable to ask to see the MO and find out from them what numbers they're looking at and how they're assessing your risk.
The study that looked at stopping at 5 years showed that risk for HR+ continues into the 20 year event horizon and the number of lymph nodes is relevant. The blue line is 1-3 positive nodes. But you've already done two extra years ... I suspect this is an area where there's a lot of uncertainty still. https://www.nejm.org/doi/full/10.1056/NEJMoa170183...
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AlabamaDee, I hope you are not feeling guilty about stopping AI at 4.5 months. AI can reduce the recurrence up to 50% and from this forum, so many women had recurrences while using tamoxifen or AI. These medications are keeping the cancer cells without their fuel to multiply but obviously, in more than 50% of cases are not killing them. In the best case senario, when the time comes to stop AI, cancer cells can be still "sleeping" or can start multiplying. It is a gamble we are all playing with our lives.
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Moth - thank you for that. So those numbers are if you stop at 5 years, not if you continue to 7-10 years? I read everything and it was a little confusing. The PA just mentioned my node involvement. She said 7 years was for early stage only. Hello? I was early stage.
I read it over again. If I read it correctly, those numbers are only if you stop after 5 years. Correct me if I'm wrong. I'm starting to lean towards taking it another 3 years!
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Homemom- the latest report is being repeated on cancer social media. Lillyishere listed it above.
“In postmenopausal women with hormone-receptor–positive breast cancer who had received 5 years of adjuvant endocrine therapy, extending hormone therapy by 5 years provided no benefit over a 2-year extension but was associated with a greater risk of bone fracture.“
You and your MO should talk about this article when making the decision. BTW I am osteopenic but cannot take bisphosphonates like prolia. My MO is happy to keep my vitamin D above 60 and increase weight bearing exercise. Bone density again in 2 years.
Lilyishere - quitting my AI at 4.5 years was probably not the issue since my MBC has the esr1 mutation the AI probably quit working.
Dee
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AlabamaDee - Thank you, I didn't see that since it was before my post. Looks like extending to 10 years still doesn't help more than 7 years, but that study doesn't go into detail like Moth's link does. I wish one would show both. I will have questions when they call back next week
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just to go further on AlabamaDee's post, Prolia is not a bisphosphonate, it is a monoclonal antibody. Zometa however is a bisphosphonate & it too is often used to boost bone density.
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HomeMom, the new study is here https://www.nejm.org/doi/full/10.1056/NEJMoa210416...
I think this is the one you should discuss with your MO and see if it applies to you. The preview doesn't give important details about the node status and how it affected the results. I can't even see if they considered only node neg pts in their study population
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Moth - so no study anywhere shows benefit for extending 5 years rather than 2. As a matter of fact, we have studies that show it increased possibility of bone fractures. I'm guessing that is why she wants me back on prolia. So three more years of Arimidex and Prolia, she thinks it will significantly decrease my chances of recurrence and protect my bones at the same time. I wonder if there is anything dertimental to doing that? I mean none of the studies suggest that anyone took a bone density drug along with the additional AI
Love this message board by the way!
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moth- thanks for the clarification on prolia. It has the same SE of potentialosteonecrosis of the jaw as the bisphosphonates so I lumped them together. I have had 5 root canals and 2 apico surgeries. I can’t risk jawbone issues. Hopefully my bone density won’t drop too fast on my trial drug.
Dee
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Important info for LOW ER+
from tweet by Dr Paolo Tarantino
"comparable outcomes b/w early TNBC and "ER-low" BC
Coherent with the recent EJC paper by Villegas et al. - showing that nearly 90% of "ER-low" cancers are basal-like tumors, behaving as TNBC"
Paper he's referring to:
"Impact of estrogen receptor levels on outcome in nonmetastatic triple negative breast cancer patients treated with neoadjuvant/adjuvant chemotherapy" https://www.nature.com/articles/s41523-021-00308-7...
"In conclusion, primary BC with ER1–9% shows similar clinical behavior to ER 1% BC. Our results suggest the use of a 10% cut-off, rather than <1%, to define triple-negative BC."
and
"the St. Gallen Consensus 2015 reported that ER expression values between 1 and 9% should be considered equivocal and that endocrine treatment alone, in the absence of chemotherapy, should not be considered a reliable adjuvant treatment for these patients."
I think the Villegas et al article he's referring to might be this one or one based on same research. I can't find an EJC version... https://cancerres.aacrjournals.org/content/79/4_Su...
bottom line seems to be that low ER might act really be much more like TN than we thought
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Here's a blog post about ErSO that I think gives some context:
https://blogs.sciencemag.org/pipeline/archives/202...
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ASCO treatment update for HER2- metastatic breast cancer
"Chemotherapy and Targeted Therapy for Patients With Human Epidermal Growth Factor Receptor 2–Negative Metastatic Breast Cancer That is Either Endocrine-Pretreated or Hormone Receptor–Negative: ASCO Guideline Update"
https://ascopubs.org/doi/full/10.1200/JCO.21.01374...
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hi everybody. I need your help: my daughter, dx triple positive in 2015, has been taking tam for four years altogether with an interruption bc of having a baby...
She has tremendous problems with tam and would like to know how long yet.
I remember reading a study here on this thread that found out there was no further benefit after 5 years IF ER positive PLUS Her2 positive. I've been searching the net for hours now but cannot find it.
Does anyone of you ladies have an idea? Would be so grateful and thx in advance.
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Apologies if this is old news. I was asked to participate in a research study, and I agreed and all it took was a blood sample. Apparently, researchers believe they have identified the genetic marker which would indicate breast cancer and could be detected in a blood sample. This would negate the need for a biopsy. I signed up without hesitation - I'm tired of the "death by a thousand cuts" process. It's called the Toray 3D-Gene Protocol: Study Sample Collection Protocol for "Analysis by EarlyGuard" of Serum miRNA from women referred for additional testing due to abnormal breast imaging classified as BI-RADS 3, 4, or 5." Fingers crossed it is successful - it'd be huge to avoid unnecessary biopsies and get to positives more widely/quickly/cheaply.
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PinkTonic It should be on the page previous to this one (92? or 91?) I was in that discussion, but you should read the posts, I don't remember what was said about HER+ patients
My doctor thinks I need to stay on them another three years (I've been on 7) because I had node involvement. They sent me this study from New England Journal Of Medicine from a Canadian study https://www.nejm.org/doi/full/10.1056/NEJMoa1604700
I'm in the middle of reading it, but if anyone else wants to take a look and interpet what it says, be my guest!
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I tried to look up that clinical trial you mentioned above. I could only come up with two clincial trials and one has been completed and the other suspended. Here are the two ClinicalTrials.gov Identifiers: NCT02127073 & NCT01231386. One was run out of Columbia University in NYC, and the other City of Hope on California. Do you know if it is one of these?
Thanks.
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ARV471 Trial scan and plan on Monday. If all is good we move scan to every 12 weeks. Still going every other week for bloodwork. I am hopeful for a good report on the cancer, but dealing with UTI, migraines, vertigo and random pains. My step mom moved to a hospice house for pancreatic cancer. It was hard to deal with my emotions for her and my thoughts of an eminent future for me. Needless to say I am dealing with the usual scanxiety. Will let you all know the results. 🙏🏻🦋
Dee
Edited-Oops I meant to put this on clinical trials thread. Cross posting there.
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Dee,
Thinking of you and hoping that all goes well on Monday. Thoughts for your step mom as well.
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