Which Patients Will Be Helped By Immune Cancer Drugs? This Test May Tell

Excerpt:

“You’ve probably heard about powerful new cancer medicines like Keytruda and Opdivo. As advertised on TV, these drugs release brakes on the immune system to make tumors disappear and extend survival in deadly diseases like lung cancer and melanoma. But these agents, called checkpoint inhibitors, work in only a fraction of patients. Scientists are searching for diagnostic tests to predict who will be helped, and who won’t.

“A promising solution comes from Foundation Medicine, a molecular diagnostics company headquartered in Cambridge, Mass. Foundation offers a cancer genome profiling test that evaluates mutations in DNA. With results from its standard FoundationOne panel, Foundation calculates a Tumor Mutation Burden (TMB) score. This quantitative readout―based on the number and type of DNA changes per megabase, a length of DNA―may prove helpful to patients considering immune treatment for many advanced forms of cancer.”

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Physicians’ Misunderstanding of Genetic Test Results May Hamper Mastectomy Decisions

Excerpt:

“A recent survey of over 2,000 women newly diagnosed with breast cancer found that half of those who undergo bilateral mastectomy after genetic testing don’t actually have mutations known to confer increased risk of additional cancers, according to a study by researchers at the Stanford University School of Medicine and four other U.S. medical centers.

“Instead the women had what are known as variants of uncertain significance, or VUS, that are often eventually found to be harmless. A bilateral mastectomy is a surgical procedure in which both of a woman’s breasts are removed after a diagnosis of in one breast.”

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Atezolizumab Demonstrates Long-Term Responses in Subset of TNBC

Excerpt:

“According to the results of a phase I study of single agent anti-PD-L1 atezolizumab (Tecentriq) in metastatic triple-negative breast cancer (mTNBC), ten percent of patients showed impressive long-term survival, although researchers said that aside from some biomarker evidence, it’s yet unclear why the drug was more effective in this subset of patients.

“Results of the study were presented this week at the AACR Annual Meeting 2017 by lead author Peter Schmid, MD, PhD, director of the St. Bartholomew’s Breast Centre at St. Bartholomew’s Hospital and Barts Cancer Institute in London.”

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When the Doctor Recommends Against the Surgery a Breast Cancer Patient Wants

Excerpt:

“More women with breast cancer are electing to have both breasts removed, even when cancer affects only one breast. The procedure, called contralateral prophylactic mastectomy (CPM), is a more complex surgery that has not been shown to improve survival.

“A new study from the University of Michigan Comprehensive Cancer Center examines the complex interaction between patients’ desires for the most extensive and surgeons’ responsibility to minimize harm.

“The population-based survey, published in JAMA Surgery, found that few patients sought a second opinion or went to a different hospital when their surgeon recommended against CPM. Further, patients were overwhelmingly satisfied with their treatment, even when their surgeon dismissed CPM with little discussion.”

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CDK4/6 Agent Active in Metastatic Breast Cancer

Excerpt:

“About one in five patients with post-chemotherapy metastatic breast cancer attained an objective response to single-agent therapy with the cyclin-dependent kinase (CDK)4/6 inhibitor abemaciclib, results of a phase II trial showed.

“Responses were durable, lasting an average of almost 9 months, and more than 40% of patients obtained clinical benefit. Abemaciclib’s safety and tolerability were consistent with previous clinical experience, as no new or unexpected adverse events occurred among 132 patients who received the drug.”

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Triple-Negative Breast Cancer Patients Who Responded to Immunotherapy Had Long-Term Survival Benefit

Excerpt:

“Among patients with metastatic triple-negative breast cancer (TNBC) who were treated with the anti-PD-L1 cancer immunotherapy atezolizumab (Tecentriq), those who responded to the medicine lived significantly longer (overall survival) compared with those who did not respond, according to data from a phase I clinical trial presented here at the AACR Annual Meeting 2017, April 1-5.

” ‘Triple-negative is an aggressive subtype of breast cancer often affecting younger women and, unfortunately, the current options for metastatic disease remain limited,’ said Peter Schmid, MD, PhD, director of the St. Bartholomew’s Breast Centre at St. Bartholomew’s Hospital and Barts Cancer Institute in London.”

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More Women With Breast Cancer Opt to Remove Healthy Breast

Excerpt:

“One in three breast cancer patients under 45 removed the healthy breast along with the breast affected by cancer in 2012, a sharp increase from the one in 10 younger women with breast cancer who had double mastectomies eight years earlier, a new study reports.

“The rate is especially high in some parts of the country, the study in JAMA Surgery found. Nearly half of younger women in five neighboring states — Nebraska, Missouri, Colorado, Iowa and South Dakota — had double mastectomies in 2010-12. Women often remove the healthy breast so they don’t have to worry about developing another cancer, even though there is no evidence that removing the healthy breast extends lives.”

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Outlook in HER2+ Breast Cancer Much Brighter Today Than 10 Years Ago, Expert Says

Excerpt:

“Over the last decade, the treatment landscape in HER2-positive breast cancer has changed dramatically, says Sara Hurvitz, MD.

” ‘I believe that a patient diagnosed today has a much greater chance of being alive 5 or 10 years from now—some of them may even be cured—and that compares very favorably with the outlook of 10 years ago when we just had 1 or 2 therapies and no evidence to support using HER2-targeted therapies after a patient’s disease grew,’ Hurvitz said.

“In an interview with Targeted Oncology, Hurvitz director of the Hematology/Oncology Breast Cancer Program and an associate professor in the Department of Medicine at the University of California, Los Angeles, discusses ongoing advances that continue to revolutionize the treatment of patients with HER2+ breast cancer.”

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New Study Finds That Most Cancer Mutations Are Due to Random DNA Copying ‘Mistakes’

Excerpt:

“Johns Hopkins Kimmel Cancer Center scientists report data from a new study providing evidence that random, unpredictable DNA copying ‘mistakes’ account for nearly two-thirds of the mutations that cause cancer. Their research is grounded on a novel mathematical model based on DNA sequencing and epidemiologic data from around the world.

” ‘It is well-known that we must avoid environmental factors such as smoking to decrease our risk of getting . But it is not as well-known that each time a normal cell divides and copies its DNA to produce two new cells, it makes multiple mistakes,’ says Cristian Tomasetti, Ph.D., assistant professor of biostatistics at the Johns Hopkins Kimmel Cancer Center and the Johns Hopkins Bloomberg School of Public Health. ‘These copying mistakes are a potent source of cancer that historically have been scientifically undervalued, and this new work provides the first estimate of the fraction of mutations caused by these mistakes.’ ”

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