Brain Mets Can Acquire HER2-Positivity in HER2-Negative Breast Cancer Patients

Excerpt:

“Brain metastases from primary breast cancer tumors often acquire clinically actionable genetic alterations, according to a small study. About one fifth of ERBB2/HER2-negative cases switched to HER2-positivity in the brain metastases.

” ‘Limited therapeutic options exist for patients with brain metastases,’ wrote study authors led by Nolan Priedigkeit, BS, of the University of Pittsburgh. ‘ERBB2/HER2-positive brain metastases have demonstrated encouraging responses to ERBB2/HER2-targeted therapies in recent clinical trials.’ ERBB2/HER2-negative brain metastases, however, have shown no such response.”

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A Breast Cancer Drug That Gets In The Brain? Cascadian Sees A Way Forward

Excerpt:

“Breast cancer patients sometimes end up dying when their tumors spread all the way to the brain. Some very good drugs already exist for patients with breast cancer, especially ones with tumors that overexpress the HER2 marker, but that success has raised a new question: Can drugmakers take another step, and fight those deadly brain metastases that get people in the end?

“Seattle-based Cascadian Therapeutics is testing that idea this week with researchers gathered at the San Antonio Breast Cancer Symposium. Cascadian is reporting today that patients who got conventional capecitabine and trastuzumab, plus an experimental small-molecule drug, tucatinib (aka ONT-380), lived a median of 7.8 months without their tumors getting worse. About 61% of patients on that triple-drug combo saw tumors shrink. It’s an impressive result, given that these patients were especially ill when they enrolled in the study, having already received a median of three prior rounds of HER2-targeted therapy. The data are also holding up over time: a snapshot of the data from June showed patients living a median of 6.3 months without their tumors spreading.”

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Icotinib Improves Intracranial PFS in EGFR-Mutant NSCLC and Brain Mets

Excerpt:

“Treatment with icotinib more than doubled intracranial progression-free survival (iPFS) compared with whole brain irradiation (WBI) combined with standard chemotherapy, according to phase III trial results presented at the 17th World Lung Cancer Conference, the Annual Meeting of the International Association for the Study of Lung Cancer (IASLC), in Vienna.

“Icotinib significantly improved median iPFS, the trial’s primary endpoint, to 10.0 months compared with 4.8 months in patients treated with WBI and chemotherapy, HR = 0.56; 95% CI, 0.36-0.90 (P = .014). Secondary endpoints of the trial, including progression-free survival (PFS) and the objective response rate (ORR), were also significantly improved with icotinib over WBI/chemotherapy. Median PFS was 6.8 versus 3.4 months, respectively (HR, 0.44; 95% CI, 0.31-0.63 [P < .001]).”

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Angiochem’s ANG1005 Shows Clinical Benefits and Prolonged Survival for Breast Cancer Patients With Brain Metastases

Excerpt:

“Angiochem, a biotechnology company developing peptide-drug conjugates uniquely capable of crossing the blood-brain barrier, recently presented data from its Phase II trial for its lead compound, ANG1005, at two highly regarded international cancer conferences: The European Society for Medical Oncology (ESMO) 2016 Congress and the European Association of Neuro-Oncology (EANO) 2016 Meeting.

“On Friday Oct 7th, 2016 at the ESMO Congress, Copenhagen, Denmark, Shou-Ching Tang, MD, PhD Leader, Breast Cancer Multidisciplinary Program, Augusta University, Augusta, GA, USA presented a podium presentation titled: ANG1005, a novel peptide-paclitaxel conjugate crosses the BBB and shows activity in patients with recurrent CNS metastasis from breast cancer, results from a phase II clinical study.”

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Immune and Targeted Therapies Combined with Radiation Therapy Improves Outcomes for Melanoma Brain Metastases Patients, Say Moffitt Researchers

Excerpt:

“Brain metastases are one of the most common complications of advanced melanoma, requiring multidisciplinary management. Patients who are diagnosed with these metastases have an expected median survival of only 4 to 5 months. Moffitt Cancer Center researchers hope to improve these survival rates following a new study in Annals of Oncology that shows novel immune and targeted therapies with radiation therapy improves the outcomes of patients with melanoma brain metastases over conventional chemotherapy.”

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Lung Cancer Patients Whose Tumour Has Spread to the Brain Could Be Spared Radiotherapy

Excerpt:

“Patients with non-small cell lung cancer which has spread to the brain could be spared whole brain radiotherapy as it makes little or no difference to how long they survive and their quality of life according to a Cancer Research UK-funded clinical trial published today in The Lancet(link is external).

“Around 45,500 people are diagnosed with lung cancer in the UK every year and an estimated 85 per cent of cases are non-small cell lung cancer. Up to 30 per cent of patients with non-small cell lung cancer have the disease spread to the brain.”

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Concurrent SRS, Immunotherapy Improved Response in Melanoma Brain Mets

Excerpt:

“Undergoing immunotherapy within a month of stereotactic radiosurgery (SRS) for the treatment of melanoma brain metastases resulted in an improved response to treatment compared with undergoing the two treatments with a longer amount of time between them, according to the results of a study published in Cancer.

“Patients in the study who underwent the two therapies within 4 weeks of each other had a significantly greater median percent reduction in lesion volume regardless of whether SRS occurred before or after immunotherapy.”

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Pembrolizumab Shows Activity in Brain Metastases from NSCLC, Melanoma

Excerpt:

“Pembrolizumab demonstrated therapeutic activity in brain metastases of patients with non–small cell lung cancer or melanoma, according to early results of an ongoing randomized phase 2 trial.

“ ‘In the United States, about 50,000 patients with metastatic melanoma or non–small cell lung cancer develop brain metastases every year. … At diagnosis, 10% of patients with metastatic NSCLC have brain metastases and another 30% develop brain involvement,’ Sarah B. Goldberg, MD, MPH, assistant professor in the department of medical oncology in the Smilow Cancer Hospital at Yale School of Medicine, and colleagues wrote. ‘Many effective drugs in development have not been well studied for central nervous system penetrations, and patients with untreated brain metastases are excluded from most clinical trials.’ ”

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Pfizer Presents Promising Data from Next Generation ALK/ROS1 Inhibitor in Advanced Non-Small Cell Lung Cancer

Excerpt:

“Pfizer Inc. (NYSE:PFE) today announced encouraging new data from a Phase 1/2 study of lorlatinib, the proposed generic name for PF-06463922, Pfizer’s investigational, next-generation ALK/ROS1 tyrosine kinase inhibitor. The study showed clinical response in patients with ALK-positive or ROS1-positive advanced non-small cell lung cancer (NSCLC), including patients with brain metastases. These data were presented today in an oral presentation at the 52nd Annual Meeting of the American Society of Clinical Oncology (ASCO) in Chicago.

“The results presented are from the dose escalation component of an ongoing Phase 1 study of patients with ALK-positive or ROS1-positive NSCLC, with or without brain metastases, who were treatment-naïve or had disease progression after at least one prior tyrosine kinase inhibitor (TKI). Among patients with ALK-positive metastatic NSCLC, the overall response rate (ORR) with lorlatinib was 46 percent, with three patients achieving complete responses and 16 patients achieving a partial response (95% CI: 31-63). The median progression free survival (PFS) was 11.4 months (95% CI: 3.4 – 16.6). The majority of patients had received two or more prior ALK TKIs. Additionally, lorlatinib showed the ability to decrease the size of brain metastases in patients with ALK-positive or ROS1-positive metastatic NSCLC.”

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