Breaking Research News from sources other than Breastcancer.org
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"@moth, to me, that sounds like another study showing survival benefit for radiation over no radiation for early stage patients"
When they found micromets in my sentinel lymph node after my BMX they were like you don't need radiation but, we'll present it to the tumor board; they recommended Radiation. When I went in for a consult I was armed with all the studies that showed there's no benefit to Rads after Mastectomy with less than 4 lymph nodes involved. The RO was like no there are new studies showing great benefits to radiation after Mastectomy with any node involvement!
Long story short, I hope that Rads + Mastectomy is the winning ticket. 😀
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In my case, the tumor board decided no radiation even though I had 2 positive nodes. I had two opinions from two large cancer centers and they all agreed on this. I really don't like it when science keep changing their recomendations.
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Are micromets when it is just a "spec" in there? I had two fully involved and two with "a spec".
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I read online that in a biopsy-
“Micrometastases are defined as clusters of cancer cells that are between 0.2 mm and 2.0 mm in diameter. Any smaller clusters are called isolated tumor cells.“
I had 1 micro metastasis in my sentinel lymph node confirmed by pathology after surgery. The surgeon took out 22 nodes because he “saw” cancer. I have suffered from chronic Lymphadema for 8 years now. Tumor board said no radiation.
Dee
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https://jitc.bmj.com/content/jitc/9/8/e002597.full.pdf
Recommendations Summarized here-
---All pts with MBC should undergo comprehensive genomic profiling, including TMB+MSI
---To test for PDL1, prioritize extrahepatic sites or primary tumor
---PDL1 should not be performed on decalcified bone
my PDL1 was from the liver and negative. 🤔
Dee
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good article makes tremendous sense! My current onc had my almost four yr old bone sample tested - PDL1 negative. Not sure what “decalcified bone” means, though.
Since I’ve never had breast surgery, I wonder if anything is left of the primary that could be tested
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https://www.nytimes.com/2021/08/17/health/breast-c...
This Breast Cancer Gene Is Less Well Known, but Nearly as Dangerous
PALB2 is not as well known as BRCA, but mutations of the gene can raise a woman's risk for breast cancer almost as much.
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This piece is full of info and, well, nearly overwhelming. Wow.
I read it earlier this am and then went back to look for it. And read it again.
Coincidentally, my search brought up this piece on the same topic from 2014! In the same paper!
Wonder how much info/data remains the same between then and now?
The 2014 piece reports: "Women with the PALB2 mutations were slightly more likely to have "triple negative" breast cancer — a form resistant to hormone treatment, more aggressive, and more likely to recur than other subtypes."
And "Over all, the researchers found, a PALB2 mutation carrier had a 35 percent chance of developing cancer by age 70. By comparison, women with BRCA1 mutations have a 50 percent to 70 percent chance of developing breast cancer by that age, and those with BRCA2 have a 40 percent to 60 percent chance. The lifetime risk for breast cancer in the general population is about 12 percent."
Still all the same?
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Education Department Announces Automatic Debt Cancellation for Over 323,000 Disabled Borrowers
... the Department of Education has finally committed to providing automatic federal loan discharges to the hundreds of thousands of disabled borrowers who have been entitled to this relief for years, totaling more than $5.8 billion in discharges. This action is long overdue and will make a huge difference in the lives of these borrowers who have been trapped in unnecessary student debt.
We're also very encouraged to see that the Department of Education plans to pursue broader changes through its upcoming rulemaking, and we look forward to working with the Department through that process to eliminate the many barriers that keep borrowers with disabilities from receiving the relief they are entitled to under law.
In the upcoming rulemaking, we're hoping that the Department will commit to eliminating the three-year monitoring period that has prevented so many borrowers from getting much needed relief under the disability discharge program. In addition, we want to see the Department take this opportunity to expand the eligibility criteria for the program to better match the intent of the law, and to find other ways to identify borrowers who miss out on relief due to our Kafkaesque student loan system.
We look forward to the Department's implementation of these changes for disabled borrowers early this fall....
Source: email dated Aug 20, 2021 by Persis Yu, Director, Student Loan Borrower Assistance Project, National Consumer Law Center
Organization web site: www.nclc.org Relevant posts: https://www.nclc.org/?option=com_content&print=pri... and https://www.nclc.org/media-center/statement-in-res...
{Web site access is free of charge. This information will be relevant to those with metastatic breast cancer. An additional source of excellent information on financial, legal and practical issues related to breast cancer is https://triagecancer.org/ }
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piqray data-
https://theoncologist.onlinelibrary.wiley.com/doi/10.1002/onco.13804
“Postadjustment, median PFS for patients treated with alpelisib in BYLieve was 7.3 versus 3.7 months in the real-world cohort, and 6-month PFS was 54.6% versus 40.1%, respectively.“
I hope this helps someone interested in recent data. I'm not eligible since Idon't have the mutation, but up to 40% of MBC patients have PIK3CA-mutated tumors.
Dee
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High tumor mutation burden fails to predict immune checkpoint blockade response across all cancer types
"In cancer types that showed no relationship between CD8 T-cell levels and neoantigen load, such as breast cancer, prostate cancer, and glioma, TMB-H tumors failed to achieve a 20% ORR (ORR = 15.3%, 95% CI 9.2-23.4, P = 0.95), and exhibited a significantly lower ORR relative to TMB-L tumors (OR = 0.46, 95% CI 0.24-0.88, P = 0.02)"
https://doi.org/10.1016/j.annonc.2021.02.006
(edited to fix link, hopefully!)
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'How Deeply Ignorant We Are' About Healthcare Pricing
The New York Times has built a database to make pricing information released under new U.S. transparency rules easier to use, and along the way revealed how hospitals charge vastly different prices for the same services.
Not all hospitals are complying with the new rule to publish the rates they negotiated with insurers, but the reporters compiled information from more than 60 hospitals that did publish, partnering with researchers from the University of Maryland-Baltimore County to turn the pricing files into a database.
They found that hospitals charge patients "wildly different amounts for the same basic services" like an x-ray or a pregnancy test.
They also found that insurers aren't always negotiating favorable rates for their customers: "In many cases, insured patients were getting prices that are higher than they would if they pretended to have no coverage at all," they wrote.
More patients have a reason to care when their insurance makes a bad deal, as high-deductible plans become increasingly popular, the Times reported. With these plans, patients could have to pay thousands of dollars before their coverage kicks in.
The reporters used patient bills involving rabies vaccine as examples. At Intermountain Medical Center in Utah, a child's dose of the two drugs to prevent rabies -- along with administration fees and ED usage charges -- cost $4,198 with Cigna; $3,704 for patients paying cash; $3,457 with Regence BlueCross BlueShield; and $1,284 for SelectHealth, which is owned by Intermountain.
In Florida, an adult dose of a rabies shot at AdventHealth Orlando ranged from $17,000 to $37,000, not including ED usage fees.
"It's not just individual patients who are in the dark," Martin Gaynor, PhD, a healthcare economist from Carnegie Mellon, told the Times. "Employers are in the dark. Governments are in the dark. It's just astonishing how deeply ignorant we are about these prices."
Source: MedPage Today https://www.medpagetoday.com/special-reports/exclu...
Link to database: https://www.nytimes.com/interactive/2021/08/22/ups...
{MedPage is free of charge but may require registration. NYT may require a subscription - not sure. This is disillusioning - but no surprise at all. We all need to be talking with our legislators IMO about a health care system that is more affordable and accessible when we need it!}
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Big development re TECENTRIQ/atezolizumab
Roche has WITHDRAWN the US accelerated approval for atezolizumab in combination with chemotherapy for the treatment of patients with advanced TNBC whose tumours express PDL1
"Roche will work with the FDA over the coming weeks to complete the withdrawal process. Roche is notifying healthcare professionals in the US about this withdrawal. Patients in the US being treated with Tecentriq for PD-L1-positive mTNBC should discuss their care with their healthcare provider."
https://www.roche.com/media/releases/med-cor-2021-...
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All I can say is thank goodness for our nhs - even if it’s not perfect by a long way!
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EANO–ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with brain metastasis from solid tumours
https://www.annalsofoncology.org/action/showPdf?pi...
- •This Clinical Practice Guideline provides management recommendations for patients with brain metastases from solid tumours.
- •The guideline covers clinical and pathological diagnosis, staging and risk assessment, treatment and follow-up.
- •Treatment and management algorithms are provided.
- •The author panel encompasses a multidisciplinary group of experts from different institutions and countries in Europe.
- •Recommendations are based on available scientific data and the authors' collective expert opinion.
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https://www.thedenverchannel.com/news/national/res...
Another article about ErSO for metastatic breast cancer, hormone positive. I found it encouraging that the researcher from Univ of Illinois said that clinical testing could be done in the next few years. What I don't understand is why were they able to push the covid vaccines (3 or 4 different ones!) to the public in a matter of months but we have to wait years for this phenomenal medicine. And WHY do they need to test it on other cancers as the next step?
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GoKale, I think it's money honestly. The population affected and who will benefit from it is much larger for covid, and govt's were going to be buying the vaccine for their citizens. The more cancers this vaccine can target, the easier for the manufacturer to bring it to market. If it only helps a small handful of people, it's cost prohibitive....
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You're right, Moth. If the new drug can help other cancers then Bayer will gain a tremendous market share.
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GoKale - thank you for posting this article! It is frustrating that the path from mouse trials to human is so much time
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Article from today’s Times newspaper on emerging trials based on Covid vaccine platform.
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Concerning ErSO, in the United States, would people that are at the end of the road as far as treatment options be able to try it under President Trump's "Right to Try"?
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Karenfizedbo - the article you posted sounds very interesting. I had read a while ago that one of the people who helped develop the Covid vaccine had been working on a cancer drug that used the same mechanism. She had to stop working on the cancer therapy to start working on the covid vaccine. So this therapy sounds further along than the ErSO drug which is encouraging.
Cowgal - I forgot about the "Right to Try", thanks! That's encouraging!
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Karenfizebo - thank you for the post. I have been hoping that the research/technology/money/science behind the Covid Vaccines will lead to better treatment/options for diseases/conditions such as cancer.
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Posted this in clinical trial thread but want to repost it here too:
Dear all, it is so cool Covid-19 helped to advance mRNA technology that is coming into cancer world. What a great idea to make your body produce leukocytes with vaccine-induced cancer antigens. I think it will become another great tool in combination with existing drugs: https://www.fiercebiotech.com/research/biontech-re.... There's also a recruiting clinical trial there for solid tumors. In my list! Hooray!
Saulius0 -
https://www.mdanderson.org/cancerwise/what-is-tumo...
This article is about TILs therapy. Judy Perkins benefited from this therapy but she also had a gene mutation. I don't know if a patient has to have a gene mutation for this to work. It also says that TILs works on solid tumors. Do you think that includes bone mets? I will ask my MO about this later this month.
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GoKale,
I'd be interested in hearing what your doc says. To my knowledge, this is still being tested. However, I had had the NIH trials bookmarked and recently pulled up that bookmark and it looks like they are not currently taking patients. I don't know if this is related to the actual testing or related to Covid stuff -- because the TIL therapy requires, to my knowledge, going in and out of the hospital for different periods of time.
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Interesting video- SBRT is becoming more of an option! But has a way to go.
Dee
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Did anyone see this - very relevant to Stage4 ER pos —https://www.sciencedirect.com/science/article/pii/S2059702921001927
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Whatayear,
Very interesting article. When I started on palbo, I read through all of the paperwork and raised with the NP assigned to my oncologist that I was taking a PPI. She passed it off and just said -- don't take them at the same time. Make sure you have a 2 hour window between the two drugs. I got about a year and a half on palbo -- sounds like her advice may not have been exactly on point.
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