CHMP Recommends Afatinib for Second-Line NSCLC

“Afatinib (Giotrif, EU; Gilotrif, US) has received a positive recommendation from the Committee for Medicinal Products for Human Use (CHMP) as a treatment for patients with advanced squamous cell non–small cell lung cancer (NSCLC) following progression on platinum-based chemotherapy, according to Boehringer Ingelheim, the manufacturer of the irreversible EGFR inhibitor.

“The CHMP opinion, which recommends that the treatment should gain approval from the European Medicines Agency in this setting, is based on data from the phase III LUX-Lung 8 trial. In the study, second-line afatinib reduced the risk of both disease progression and death by 19%, compared with erlotinib (Tarceva) in patients with advanced squamous cell carcinoma of the lung.”


New Image Analytics May Offer Quick Guidance for Breast Cancer Treatment

“For women with the most common type of breast cancer, a new way to analyze magnetic resonance images (MRI) data appears to reliably distinguish between patients who would need only hormonal treatment and those who also need chemotherapy, researchers from Case Western Reserve University report.

“The analysis may provide women diagnosed with estrogen positive-receptor (ER-positive)  answers far faster than current tests and, due to its expected low cost, open the door to this kind of testing worldwide.

“The research is published in the journal Nature Scientific Reports.”


Putting Immune Checkpoint Blockade to the Test in Breast Cancer


About 10 months ago, we asked: Is There a Future for Immunotherapy in Breast Cancer? Now, we can answer this question with a qualified “yes.” The data show why:

Triple-negative breast cancer (TNBC)

TNBC has long been considered to be more amenable to immune system-based treatments than other types of breast cancer because it is more immunogenic; that is, relatively high levels of immune cells accumulate within or adjacent to TNBC tumors. These immune cells could be triggered to attack tumors if properly activated. TNBC tumors are also likely to have a higher mutational burden (number of genetic mutations). This is one of the predictors of sensitivity to a type of treatment called immune checkpoint blockade.  Drugs known as checkpoint inhibitors block the proteins PD-1 or PD-L1. In cancer, PD-L1 proteins on tumor cells bind to PD-1 proteins on immune T cells and inhibit their tumor-killing activity. Immune checkpoint drugs disable this interaction and enable activation of T cells. These drugs are actively being explored in TNBC in clinical trials.

Continue reading…


Targeted Axillary Dissection of Lymph Nodes after Chemotherapy Improves Staging Accuracy of Node-Positive Breast Cancer

“A new procedure developed by surgeons at The University of Texas MD Anderson Cancer Center improves the accuracy of axillary staging and pathologic evaluation in clinically node-positive breast cancer, and reduces the need for a more invasive procedure with debilitating complications.

“The research, published in the Journal of Clinical Oncology, has changed treatment guidelines at the institution for a select group of breast cancer patients with lymph node metastasis, who will now receive Targeted Axillary Dissection (TAD).

“The TAD procedure involves removing sentinel lymph nodes, as well as additional cancerous lymph nodes found during diagnosis. At the time of diagnosis, those select nodes are clipped for identification during later surgery.”


Afatinib Shows Clinical Benefit for Lung Cancer Patients with Brain Metastases

“Non-small cell lung cancer (NSCLC) patients with common epidermal growth factor (EGFR) mutations and brain metastases showed improved progression-free survival (PFS) and response from the EGFR tyrosine kinase inhibitor (TKI) afatinib compared to standard platinum doublet chemotherapy.

“More than 25% of with advanced NSCLC experience progression to the brain from their primary lung and this number increases to 44-63% for those NSCLC tumors driven by EGFR mutations. Prognosis is poor and typically ranges for 1-5 months for those with . EGFR TKIs are highly effective therapies for advanced NSCLC driven by EGFR mutations, especially the common mutations, exon 19 deletions and L858R point mutations. Even though there are a number of EGFR TKIs approved for first-line therapy of EGFR mutation positive NSCLC, there is a scarcity of prospective data for EGFR TKIs in patients with brain metastases.”


Early Chemotherapy Improves Survival for Men with Prostate Cancer

“Two papers from UCL show that having early chemotherapy improves survival for men with prostate cancer. The papers, published in the Lancet and Lancet Oncology, report the results from the STAMPEDE clinical trial and a meta-analysis.

“Both papers looked at the use of a chemotherapy drug called docetaxel. Docetaxel is already used for men with prostate cancer once hormone therapy has stopped working. In STAMPEDE and the meta-analysis, the researchers looked at using it earlier, when men are starting long-term hormone therapy. Both studies found that adding docetaxel improved survival for these men.

“The studies also looked at whether the drug zoledronic acid improves survival. Zoledronic acid is used to reduce the risk of bone problems in men whose cancer has spread to their bones, and whose hormone therapy has stopped working. The new studies looked at using it earlier, when men are starting long-term hormone therapy. Both studies found that adding zoledronic acid did not improve survival for these men.”


Capecitabine Improved Outcomes for Breast Cancer Patients with Disease after Presurgery Chemo

“Treatment with the chemotherapy agent capecitabine increased disease-free survival for women with HER2-negative breast cancer that was not eliminated by presurgery chemotherapy, according to results from the phase III CREATE-X clinical trial presented at the 2015 San Antonio Breast Cancer Symposium, held Dec. 8-12.

“Treatment given to shrink or eliminate a tumor before surgery is called neoadjuvant therapy. In some patients with breast cancer treated with neoadjuvant chemotherapy, residual invasive cancer can be detected in breast tissue samples and lymph nodes removed during surgery. These patients tend to have worse long-term outcomes compared with women who respond completely to neoadjuvant therapy.

” ‘It has been suggested that patients with residual invasive disease after neoadjuvant chemotherapy have chemoresistant breast cancer, but there have been no large-scale clinical trials to test whether adjuvant systemic chemotherapy is beneficial for these patients,’ said Masakazu Toi, MD, PhD, a professor at Kyoto University Hospital in Japan, and founder and senior director of the Japan Breast Cancer Research Group (JBCRG). ‘CREATE-X was designed to evaluate this clinical question by testing whether capecitabine could improve disease-free survival for patients with residual invasive disease after neoadjuvant chemotherapy.’ “


Drugs Prevent Heart Damage during Breast Cancer Treatment, Study Shows

“Heart medication taken in combination with chemotherapy reduces the risk of serious cardiovascular damage in patients with early-stage breast cancer, according to results from a new landmark clinical trial.

“Existing research has shown some cancer therapies such as Herceptin greatly improve survival rates for , but come with a fivefold risk of heart failure—a devastating condition as life-threatening as the cancer itself.

“A new five-year study, led by researchers at the University of Alberta and Alberta Health Services and funded by the Canadian Institutes for Health Research (CIHR) and Alberta Cancer Foundation, shows that two kinds of heart medications, beta blockers and ACE inhibitors, effectively prevent a drop in heart function from cancer treatment.”


Mindfulness-Based Stress Reduction Diminishes Chemo Brain

“Participation in a mindfulness-based stress reduction program yields robust and sustained improvement in cancer-related cognitive impairment, a prevalent and potentially debilitating condition that affects attention, memory and executive function in survivors, according to a new study from the Regenstrief Institute and Indiana University School of Medicine.

“Although cancer-related cognitive impairment, sometimes referred to as chemo brain or post-cancer cognitive fuzziness, is common among survivors—disrupting social relationships, work ability, self-confidence, and quality of life—clinicians have few treatment options to offer. Cognitive deficits have been seen to persist for more than a decade following cancer treatment for many survivors.

” ‘Randomized Controlled Pilot Trial of Mindfulness-based Stress Reduction for Breast and Colorectal Cancer Survivors: Effects on Cancer-related Cognitive Impairment,’ published online in advance of print in the Journal of Cancer Survivorship, is the first randomized clinical trial to evaluate the effects of mindfulness-based stress reduction, known as MBSR, on fatigued breast and colorectal cancer survivors, the majority of whom had been treated with chemotherapy.”