Topic: Breaking Research News from sources other than Breastcancer.org

Oct 8, 2020 04:44AM Karenfizedbo15 wrote:

Hope all goes well Lynne!

Oct 8, 2020 11:50PM BSandra wrote:

Dear Lynn, thanks for explanation. I am all hands for local treatments, just it was interesting how they make these decisions. Seems like your doctors are very much involved with your case and that is just great to hear. All the best for you, please keep us posted... Saulius

Oct 10, 2020 11:21AM Lumpie wrote:

PracticeUpdate Editorial Team October 09, 2020

Incidence of the disorder was found to be clinically relevant.

Avulsive or other dental treatment has been shown to be a risk factor for denosumab-induced osteonecrosis of the jaw in patients with bone metastases. The incidence of the disorder was found to be clinically relevant.

This outcome of a retrospective, observational study was reported at the virtual 11th Research Congress of the European Association of Palliative Care (EAPC).

{Physicians in Itally} set out to assess the incidence of osteonecrosis of the jaw in patients receiving denosumab and to evaluate the role of potential risk factors.

In 753 patients followed for a median of 17 months, 55% and 19% suffered from breast and prostate cancer, respectively, and 9.3% had undergone antibiotic prophylaxis before treatment. Denosumab was administered a mean of 15 (interquartile range, 6-24) times.

Overall, 53 patients (7%) developed osteonecrosis of the jaw (24-month crude cumulative incidence, 5.9%; 95% CI, 4.3-8.1).

Multiple regression results indicated the strongest predictive factor for osteonecrosis of the jaw to be avulsive or other dental treatment (P < .001).

Older age was significantly associated with a lower incidence of osteonecrosis of the jaw (P = .032).

Despite a lack of significance due to a small number of events of osteonecrosis of the jaw, chemotherapy or hormone therapy and angiogenesis inhibition were associated, respectively, with a lower and higher incidence of osteonecrosis of the jaw.

The role of angiogenesis inhibition deserves attention with regard to its relation to osteonecrosis of the jaw in patients with bone metastases.

www.practiceupdate.com/C/10786...

{Registration, no fee, may be required to access article.}

Oct 10, 2020 11:59AM Lumpie wrote:

MinusTwo: I don't have bone mets so I'm not super up on some of the necrosis concerns. I happen to know a couple of people who have had issues recently so I am somewhat attentive to related issues. I consulted Dr. Google and came up with a couple of articles referencing "a delicate surgery extraction or nontraumatic avulsion of the teeth" and "treated via nontraumatic avulsion and closure..." so I take this to be a particular technique for either extraction or something related/similar. Perhaps others can enlighten us. Thx.

Oct 10, 2020 12:39PM illimae wrote:

Lumpie, brain mets can be very difficult when you suspect them but doctors don’t want to order the MRI without clear symptoms. Being HER2+ and having an MO who specializes in it and brain mets, I was lucky but I have suggested that others fake a headache if necessary to get the scan. I hate to do that but sometimes we have to force the issue.

Oct 10, 2020 01:34PM BevJen wrote:

Lumpie,

Some of us are old enough to remember a lot about the "military-industrial complex" and the controversies over that. Now, we are living with the "big Pharma medical complex" and, as you said, we are just a cog in the wheel. It is incredibly ridiculous that more attention is not paid to this. Yesterday I had a conversation with someone who seemed to be fairly intelligent and well educated. When I said that I had metastatic breast cancer, here was her response: oh, BC runs in my family. I get regular mammograms. But what is metastatic BC? That just goes to show that even though there are those ridiculous commercials with all of the people so happy to have MBC, there is not only a services gap for us, there is a recognition gap. And to top it all off, even medical education must be against us bc so many docs think that you cannot do anything for MBC folks. Very frustrating.

Oct 11, 2020 06:23AM JCSLibrarian wrote:

Early on in my diagnosis, my MO told me in a sad voice that my only options for treatment were systemic chemo infusions. And those would not be very long as MBC was basically a death sentence, more for palliative care. I thought to myself this cannot be true! With my background in research, I looked through PubMed for information and treatments for my disease. I was able to locate many articles on using systemic chemo coupled with localized treatments to treat ogliometastic breast cancer. I am currently NED and no longer having infusions. The MO says he is now treating me with curative intent due to my research and persistence.

Many thanks to the info I was able to get from BCO and this thread especially. My MO says he may be leery of treating any more librarians as they keep him on his toes and thinking. LOL!

Oct 11, 2020 09:11AM Bliss58 wrote:

I agree with all the sentiments here about early MBC dx. Re: brain MRIs, although Her2 tends to move to the brain, scanning is not standard of care without symptoms. After year two of my dx, I talked it over with my MO saying we scan my body, but never my brain and I'd like to know sooner than later. She told me insurance will not pay without symptoms, "so give me something." It is sad that we must lie to get what we need, but she agreed and ordered the MRI. She listed that I was experiencing vertigo. Now that I have history, she's able to order one each year without me requesting or giving symptoms. It all can be so frustrating for us and MOs.

Oct 11, 2020 02:11PM - edited Oct 11, 2020 02:11PM by TectonicShift

I think brain MRIs should be standard. My grandmother died of breast cancer in the brain in the '70s. Okay there wasn't so much testing to do back then. But about 8 years ago a friend died of ovarian cancer in the brain. They had been scanning her body and thought she was NED from ovarian. Until one night she had a seizure. She was gone by morning. No one checked her brain.

Oct 11, 2020 02:29PM - edited Oct 11, 2020 02:31PM by Olma61

Thank you, it is good to know they may be exploring this issue in research, Lumpie.

I am one who kind of exaggerated some real symptoms I was having at diagnosis, in order to get a brain MRI. The second time I had one, I had some real symptoms and got the MRI in the ER (but no brain mets found). My former MO once discussed having another one done, after one of her other patients insisted on it and did indeed have brain mets. But then she discouraged me, saying, well, if we find anything then you have to go through an MRI every 2 months. I declined simply because, at that point, I really DIDN'T want to look for a problem. But, in reality, yearly screening brain MRIs would make sense.

As for "give me something" I remember when I went for my spine rads, the nurse asked if I was having pain. I replied "only if my insurance co. wants me to". She laughed. That statement can actually be taken two ways, couldn't it? : o

I really do agree that MBC patients are still being "written off" in many ways, although so many of us are outliving the current "median OS" stats. They've given us some more effective treatments, maybe they should start treating us as if MBC already IS the proverbial "chronic disease" that it one day may become.

Oct 11, 2020 05:14PM moth wrote:

ESR1 Mutations and Overall Survival on Fulvestrant versus Exemestane in Advanced Hormone Receptor–Positive Breast Cancer: A Combined Analysis of the Phase III SoFEA and EFECT Trials

https://clincancerres.aacrjournals.org/content/26/...

& plain language summary: "Patients with metastatic breast cancer carrying a particular mutation fare better on one form of hormone therapy than another and can be identified using a blood test, according to a new study.

In a combined analysis of two major Phase III clinical trials, called SoFEA and EFECT, researchers were able to show that patients with advanced hormone-receptor positive breast cancer, which has developed a mutation in its androgen receptors called ESR1, fared better on a hormone therapy drug called fulvestrant, compared with another called exemestane." https://www.icr.ac.uk/news-archive/new-study-sheds...

ESR1 can be identified through liquid biopsy

Oct 12, 2020 02:55PM buttonsmachine wrote:

JCSLibrarian, I love your story! That is very encouraging. I'm glad that your MO was open minded too.

Oct 13, 2020 04:08PM moth wrote:

I might have missed this earlier in the year but the SABCS 2019 videos are available for free online

https://watch.ondemand.org/sabcs2019.htm

Oct 15, 2020 03:49PM Lumpie wrote:

MedPage Today October 14, 2020

For breast cancer patients receiving neoadjuvant chemotherapy (NACT), long-term oncologic outcomes for immediate breast reconstruction with nipple- or skin-sparing mastectomy were comparable to total mastectomy without reconstruction, a case-control study from Korea found.

https://www.medpagetoday.com/hematologyoncology/br...

Primary Source: JAMA Surgery

Source Reference: Wu ZY, et al "Long-term oncologic outcomes of immediate breast reconstruction vs conventional mastectomy alone for breast cancer in the setting of neoadjuvant chemotherapy" JAMA Surg 2020; DOI: 10.1001/jamasurg.2020.4132.

Secondary Source: JAMA Surgery

Source Reference: Fayanju OM, et al "Oncologic outcomes after neoadjuvant chemotherapy and postmastectomy breast reconstruction" JAMA Surg 2020; DOI: 10.1001/jamasurg.2020.4138.

{Free access to press coverage. Log in may be requited. Not sure about Journals - may charge a fee.}

Oct 16, 2020 08:32AM Lumpie wrote:

Cancer First published: 12 October 2020

The importance of addressing adverse financial effects of cancer among adolescents and young adults (AYAs) is paramount as survival improves. In the current study, the authors examined whether cancer‐related employment disruption was associated with financial hardship among female AYA cancer survivors in North Carolina and California.

Financial hardship related to employment disruption among female AYA cancer survivors can be substantial. Interventions to promote job maintenance and transition back to the workforce after treatment, as well as improved workplace accommodations and benefits, present an opportunity to improve cancer survivorship.

https://acsjournals.onlinelibrary.wiley.com/doi/10...

https://doi.org/10.1002/cncr.33190

{Free access to abstract. Fee for full article.}