Breaking Research News from sources other than Breastcancer.org
Comments
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Sorry for my delay in answering. Under NCT04052555 in the Exclution section the 5th dot says metastatic disease. So maybe it’s just for BC and not MBC
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AlabamaDee - disappointing to read that MDACC (The University of Texas MD Anderson Cancer Center ?) doesn't practice what they seem to preach. After reading Lorenzo Cohen and Alison Jeffires "Anti Cancer Living" , I had more hope for integrated and new approaches. I think they are or were based out of MDACC. Not medical DRs but part of an integrative approach used at MDACC focusing on lifestyle. I looked into trials a year o so ago, I wish I had known more at the time . When I called once place after my MO sent records, they said they had nothing for me, and probably wouldn't prescribe anything different than my MO had. It seems like my MO mad the comment that my history with cancer is unusual/rare, that the cancer itself is not - that it is one of the most common kinds of BC
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Here are two new articles on MBC from Practice Update:
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New article..
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Joyner
I’m so excited you posted that article about ablative radiation. I am sending it to both my MOs. Neither thought my SBRT to the single lung lesion would have much effect on OSR since there was no study. Now there is!!!
My RO was quick to say SBRT was feasible.She is fantastic and warned me that while she saw real benefit, there wasn’t a lot of long term data. I bet she already has a copy of this article to show to the MO community.
Thanks for posting.
Dee
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Joyner, very interesting article on SABR. Thanks for posting!
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Quoted by Dee above: "the precision-medicine approach targets the genetic abnormality in the tumour, regardless of where it is."
It is starting to happen. I am in a Phase 2 basket trial that is testing neratinib for tumors with ERBB2 mutations. The trial has arms for various types of cancer (including cervical, salivary gland, lung, bladder, breast), the common requirement being that they have an ERBB2 mutation or related EGFR exon 18 mutation.
P.S. It's working!
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ShetlandPony that is amazing!
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So happy to hear Shetland Pony!
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ShetlandPony: Yeah! That is great news. I knew you were in a clinical trial but couldn't recall which one.
For others interested in this topic, I am also in a clinical trial. It is the Aviator trial. Long story short, it seeks to harness the immune system to attach cancer. Won't get my first set of scans for a month or so. You can read more about the trial here:
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Thanks Lumpie! That's interesting and hopefully successful. Would be great if we could figure out away to use the bodies natural defense system to kill cancer.
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yay Shetland Pony- great news
Lumpie- hoping for good results!
I’ve been contacted to submit to a Neuroendocrine trial at UCSF -Keytruda with taxol or keytruda with Camptosar. I’m excited to be considered, but it would be too far from home for the number/ frequency of Infusions required. Still looking for something to put in my pocket should my current line fail.
Dee
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Great news, Shetland! Keep us posted!!
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Functional Status May Predict Outcomes in Hospitalized Patients With Advanced Cancer
A new study is suggesting many hospitalized adults with advanced cancer have problems with functional impairment and this is affecting their outcomes. The study findings, which were published in JNCCN — Journal of the National Comprehensive Cancer Network, revealed that 40.2% of hospitalized patients with advanced, incurable cancer were functionally impaired at the time of hospital admission. The study also showed that functional impairment was associated with higher rates of pain, depression, anxiety, longer hospital stays, and worse survival.
Lage DE, El-Jawahri A, Fuh CX, et al. Functional impairment, symptom burden, and clinical outcomes among hospitalized patients with advanced cancer. J Natl Compr Canc Netw 2020;18(6):747–754.
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High Prevalence of Urinary Incontinence With Breast Cancer Suggests Potential Overlap of Risk Factors
Urinary incontinence was highly prevalent at diagnosis in women with early-stage breast cancer, a prospective, observational study has found. These findings were reported in the Journal of the National Comprehensive Cancer Network.
...approximately 80% of patients had prevalent urinary incontinence at baseline.
"The incidence [of urinary incontinence] we observed seems higher than one would expect of women in this age group without breast cancer," noted the study authors. "This frequency raises the question of whether risk factors for developing breast cancer overlap with those for developing [urinary incontinence], an extremely common problem in breast cancer survivors."
They ... identified a need for management approaches for patients with cancer experiencing urinary incontinence, given that survivorship guidelines from the National Comprehensive Cancer Network (NCCN) do not currently address this issue.
1. Chung CP, Behrendt C, Wong L, Flores S, Mortimer JE. Serial assessment of urinary incontinence in breast cancer survivors undergoing (neo)adjuvant therapy. J Natl Compr Canc Netw. 2020;18(6):712-716.
2. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Survivorship V1.2020 — March 17, 2020. Accessed June 26, 2020. https://www.nccn.org/professionals/physician_gls/pdf/survivorship.pdf
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A quick peek at "risk factors for incontinence" finds: BMI, smoking, and diabetes are among risk factors for incontinence-- these are also cancer higher-risk groups...
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Lumpie, fingers crossed for great progress on your trial!
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Lumpie - thanks for posting the incontinence associations with BC. It is so interesting the various associations with cancer with other medical problems. Does one suggest the other? Years ago, ong beore any BC, I complained about more frequent/urgent peeing issues. Assumptions were, well I'm getting older, perimenopausal etc, maybe the fibroids. Just wish there were better very early detection tests, long before any lump shows up
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post treatment incontinence issues may be due to neuropathy. Early on I mistakenly assumed only feet and hands were affected but urethra and eye neuropathy are also possible.
Also any hormone blockers can exacerbate it as drop in estrogen is a factor in incontinence.
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Moth, yes, the article implies that there may be a connection to estrogen (which is not surprising).
BlueGrilRedState: Yes, I am so hopeful that better detection and very early treatment methods will evolve. I think that if we can really make progress on the CTC and cfDNA testing, maybe we will be able to detect cancer super early and rev up the immune system with immunotherapies to knock out a whole lot of cancer before it ever becomes clinically detectable.
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Phesgo Approval Allows for Faster Administration of Pertuzumab and Trastuzumab
The Food and Drug Administration (FDA) has approved Phesgo™ (pertuzumab, trastuzumab, hyaluronidase-zzxf; Genentech), in combination with chemotherapy, for the treatment of early and metastatic HER2-positive breast cancer.
Phesgo is a fixed-dose combination of pertuzumab (Perjeta®) and trastuzumab (Herceptin®), HER2/neu receptor antagonists, and hyaluronidase, an endoglycosidase used to increase the dispersion and absorption of coadministered drugs via subcutaneous drug delivery.
Phesgo is administered subcutaneously (SC) into the thigh by a healthcare professional at either a treatment center or in a patient's home. It is administered over approximately 8 minutes for the initial loading dose and approximately 5 minutes for each subsequent maintenance dose.
"...it makes the treatment process more efficient for patients, to be able to receive a drug subcutaneously instead of intravenously. A home administration protocol for this subcutaneous formulation is an area of current research and can be advantageous for patients and infusion centers, especially during the current pandemic."
85% of patients (n=136 out of 160) preferred Phesgo SC ...
https://clinicaltrials.gov/ct2/show/NCT03674112?term=PHranceSCa&draw=2&rank=1
ClinicalTrials.gov Identifier: NCT03674112
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Efficacy and Safety of T-DM1 + Capecitabine vs T-DM1 Alone in Previously Treated ERBB2+ Metastatic Breast Cancer
- JAMA Oncology
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FDA OKs Bavencio as first-line bladder cancer therapy
Bavencio, or avelumab, Pfizer and Merck's immunotherapy, was approved by the FDA as a maintenance treatment for patients who have locally advanced or metastatic bladder cancer whose disease didn't progress after undergoing first-line platinum-containing chemotherapy.
Avelumab is already approved in bladder cancer patients whose disease has progressed following chemotherapy. Bavencio has been approved for maintenance treatment of patients with locally advanced or metastatic urothelial carcinoma that has not progressed with first-line platinum containing chemotherapy. Avelumab is indicated for the treatment of metastatic Merkel cell carcinoma (MCC).
BAVENCIO® (avelumab) is the FIRST and ONLY FDA-approved human anti-PD-L1 immunotherapy with DUAL ENGAGEMENT of both the adaptive and innate immune systems. BAVENCIO has been shown to release the suppression of the T cell-mediated antitumor immune response by blocking the interaction of PD-L1 with PD-1 receptors in preclinical models. BAVENCIO has also been shown to induce NK cell-mediated direct tumor cell lysis via antibody-dependent cell-mediated cytotoxicity (ADCC) in vitro.
https://pharmaphorum.com/news/fda-approves-pfizer-merck-kgaas-bavencio-in-first-line-bladder-cancer/
{Avelumab is currently being studied as a therapy for HER2+ MBC in the Aviator clinical trial.}
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Efficacy and Safety of T-DM1 + Capecitabine vs T-DM1 Alone in Previously Treated ERBB2+ Metastatic Breast Cancer
- The authors of this phase I/II randomized clinical trial of 161 patients with previously treated ERBB2-positive metastatic breast cancer compared trastuzumab emtansine (T-DM1) with T-DM1 plus capecitabine. The overall response rate was numerically higher with combination therapy (44% vs 36%; P = .34). The median progression-free survival was similar between groups. Toxicity was higher with the addition of capecitabine, and more patients discontinued treatment due to adverse events in the combination arm compared with the T-DM1 monotherapy arm.
- Chemotherapy adds only modest potential benefit to T-DM1 while increasing toxicity.
- Adding capecitabine to T-DM1 did not statistically increase ORR associated with T-DM1 in patients with previously treated ERBB2-positive mBC. The combination group reported more AEs, but with no unexpected toxic effects.
doi:10.1001/jamaoncol.2020.1796{For the sake of clarity, it seems that HER2+ breast cancer is now being called ERBB2-positive breast cancer. I think it is a more specific reference to the mutation that causes the problem (uncontrolled growth) but I haven't seem a concise explanation for the change in practice.}0 -
EMA speeds review of AZ, Daiichi Sankyo HER2 drug Enhertu
The European Medicines Agency will fast-track its review of AstraZeneca and Daiichi Sankyo's HER2-positive breast cancer candidate Enhertu, or trastuzumab deruxtecan. The FDA approved the antibody drug conjugate as a treatment for metastatic HER2-positive disease in December.
http://www.pmlive.com/pharma_news/ema_fast-tracks_review_of_azdaiichi_sankyos_her2_drug_1344455
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Wow Lumpie, that is very good news... I think a drug with such profile, if approved in EU, would be compensated in my country pretty soon (I mean in a year/few years). Hopefully... Saulius
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just got this in my email
so I wasn’t aware of an immunohistochemical prognostic model score. Now there is a modified mICH4 that can possibly help doctors know if they should give hormone therapy or chemotherapy first.
Can anyone shed some light on this?
Dee
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