Use of Complementary, Alternative Medicine Affects Initiation of Chemotherapy

Excerpt:

“Women with early-stage breast cancer for whom chemotherapy was indicated and who used dietary supplements and multiple types of complementary and alternative medicine (CAM) were less likely to start chemotherapy than nonusers of alternative therapies, according to latest research led by Heather Greenlee, ND, PhD, associate professor of Epidemiology at Columbia University’s Mailman School of Public Health. This is one of the first studies to evaluate how complementary and alternative medicine use affects decisions regarding chemotherapy. Findings are available in JAMA Oncology.

“Dr. Greenlee and colleagues studied a group of 685 women with early-stage breast cancer who were recruited from Columbia University Medical Center, Kaiser Permanente Northern California, and Henry Ford Health System and enrolled 2006-2010. The women were younger than 70 with non-metastatic invasive breast cancer.”

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Common Prostate Cancer Treatments Suppress Immune Response and May Promote Relapse

Excerpt:

“Prostate cancer patients and their doctors may want to think twice about the best timing for chemotherapy or radiation therapy in conjunction with a common nonsurgical treatment, based on international research findings led by UT Southwestern Medical Center investigators.

“Researchers using mouse models found that many medical androgen deprivation therapies (ADTs) – the most commonly used nonsurgical treatments for prostate cancer – may suppress patients’ adaptive immune responses, preventing immunotherapies from working if both treatments are used but not sequenced properly. ADTs are anti-hormone therapies that decrease the body’s levels of androgens, the type of hormone that is required for prostate cancer to survive and grow.

“The study findings were published this week in Science Translational Medicine.”

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Crizotinib Tops Chemo for ALK-Positive NSCLC With Brain Metastases

Excerpt:

“First-line crizotinib therapy offered better intracranial disease control rate (IC-DCR) than chemotherapy in patients with ALK-positive non–small-cell lung cancer (NSCLC) and stable treated brain metastases, according to results of a phase III study.

“Earlier results from the ongoing PROFILE 1014 trial showed that crizotinib offers better progression-free survival (PFS) and response rates compared with pemetrexed-platinum chemotherapy. ‘Although the development of targeted therapies has improved outcomes for selected patient populations with oncogenic driver mutations, brain metastases are frequent and result in significant morbidity and mortality in patients with lung cancer,’ wrote study authors led by Benjamin J. Solomon, MBBS, PhD, of the Peter MacCallum Cancer Centre in East Melbourne, Australia.”

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Oncotype Dx Gene Test Has a Big Impact on Oncologists' Chemo Recommendations

Excerpt:

“The 21-gene Recurrence Score (RS) assay significantly influenced clinicians’ decisions to recommend breast cancer patients for adjuvant chemotherapy, analysis of a population-based dataset showed.

“Used to predict disease recurrence and benefit of chemotherapy in estrogen receptor-positive, lymph node-negative early-stage breast cancer (EBC), the assay had the strongest association with recommendation for chemotherapy, with an adjusted odds ratio (aOR) of 83 for high assay scores and 12 for intermediate scores, both relative to low scores.

“Test use was significantly associated with younger age, white race, academic centers, private insurance, and pT2/pN0(i+) grade 2 to 3 disease, Peter Kabos, MD, of the University of Denver, Aurora, CO, and colleagues reported online in the Journal of Clinical Oncology.”

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EBCC-10 NEWS: Chemotherapy Every Two Weeks for Premenopausal Breast Cancer Patients Improves Survival and Does Not Increase Risk of Early Menopause

“Amsterdam, The Netherlands: Premenopausal women with breast cancer have a better chance of survival if they are given cycles of adjuvant chemotherapy closer together, every two weeks rather than every three weeks. Furthermore, this regimen, known as “dose-dense” adjuvant chemotherapy, does not seem to be associated with an increased risk of treatment induced early menopause.

“The findings will be presented today (Thursday) at the 10th European Breast Cancer Conference (EBCC-10) and the researchers say they are important for helping younger breast cancer patients and their doctors to make better-informed decisions about the choice of chemotherapy regimens that are given in addition to other treatments such as surgery, hormone therapy and radiotherapy.

“Dr Matteo Lambertini, MD, a medical oncologist at IRCCS AOU San Martino-IST, National Institute for Cancer Research, Genoa, Italy [1], and at the Institut Jules Bordet, Brussels, Belgium, will tell the conference: ‘Our results confirm the superiority of dose-dense chemotherapy as compared to standard interval regimens in premenopausal patients at higher risk of relapse, and its use should be implemented in Europe, as it is in the United States.’ ”


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.

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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.”