Women whose immune cells were clustered together around breast cancer cells have a better chance of survival, said scientists at The Institute of Cancer, London...
So far the test is being trialled only on women with a type of breast cancer called oestrogen receptor negative (ER negative), which affects up to one in three patients and is particularly hard to treat.
But researchers plan to extend testing to cover women with the more common form of the disease.
Dr Yinyin Yuan, Team Leader in Computational Pathology and Integrative Genomics at The Institute of Cancer Research, London, said: ‘Our research is aiming to develop completely new ways of telling apart more and less aggressive cancers, based on how successful the immune system is in keeping tumours in check.
Breast cancer is the most frequently diagnosed cancer globally and the leading cause of cancer-related death in women. However, the incidence of breast cancer has somewhat stabilized over the past few decades, and breast cancer mortality appears to be declining, suggesting a benefit from the combination of early detection and more effective treatment
From a surgical standpoint, said Dr. Gradishar, axillary lymph node dissection was the standard of care in 1996. Today, the less invasive sentinel lymph node (SLN) biopsy is the standard of care for patients with early-stage breast cancer to determine spread of the disease, which has removed the risk of unnecessary extensive lymph node removal, as well as decreased the risks of post-surgical complications.
"How we thought about adjuvant therapy has changed," said Dr. Gradishar. "Physicians used to look at the number of nodes as a determinant of whether a patient was a candidate for chemotherapy, as well as what kind of chemotherapy was appropriate. Now we use genomic profiling to influence our decision-making. Additionally, the chemotherapy regimens have changed and endocrine therapy options have expanded, as has the duration of therapy."
Indeed, genomic testing and targeted therapies have changed the course of breast cancer treatment. In particular, according to Dr. Gradishar, 20 years ago human epidermal growth factor receptor (HER2)-positive disease was not listed in the guidelines, and today the NCCN Guidelines recommendations include a cadre of successful neoadjuvant and adjuvant chemotherapies for people with HER2-positive disease.
"Each year, the Food and Drug Administration approves dozens of drugs, but often those medicines don't make a huge difference to people with disease. That's because these "new" drugs are often very much like existing medicines — or are, in fact, existing medicines, approved for a slightly different purpose.
But every now and then the FDA approves a truly new drug. And that's the story of Pfizer's palbociclib, brand name Ibrance, which the agency approved for the treatment of a common form of advanced breast cancer.
"What you're seeing here is a very important step in the right direction. But it's one step, and we have to follow the journey out to the very end, which is preventing metastasis as well as preventing cell division."
- Dr. Larry Norton, Memorial Sloan Kettering Cancer Center
The story of this drug illustrates the challenging road that connects a fundamental discovery in biology to a pill that can make a difference.
This pill's story began years ago in academic labs that were churning out the basic science that explains biology but rarely makes the headlines. Scientists who were trying to understand how healthy cells divide uncovered one critical step in that process, a step controlled by a set of enzymes known (for short) as CDK4/6.
"Last month, thousands of Marines and their families were blocked in federal court from pursuing their claim that the government had given them cancer. The decision, involving people exposed to contaminated drinking water while stationed at Camp Lejeune, a base in North Carolina, didn’t consider the science.
The genetic mutations that cause cancer can take decades to manifest themselves, far longer than the North Carolina statute of repose allowed. But the laws we cobble together often trump those of science. And even when legal obstacles can be overcome, a link between a cancer and environmental pollutants is exceedingly difficult to establish, whether in a laboratory or a court of law….
Especially puzzling were some 80 Lejeune veterans who came forward with diagnoses of male breast cancer, some at an unusually early age. The annual incidence of this condition is about 1.4 cases per 100,000 men — about 1 percent of the rate for women."
Susan Zager's insight:
This is shocking. There's no reason these marines and their families should be blocked by the court. because of the claim by the court of appeals that it "had come too late." This article brings about the important science being missed and how we hope that this case can come to life with the right legal action to bring life to this important case.
The biotech company, the subject of a 2013 Supreme Court ruling that genes cannot be patented, said it was giving up trying to stop other companies from offering tests.
Susan Zager's insight:
According to the article, "Settlements have been reached with LabCorp, Invitae and Pathway Genomics. Mr. Rogers said Myriad was in talks with Ambry, Quest Diagnostics, GeneDx and Counsyl." It's about time!
A new analysis shows that many women with breast cancer may lack knowledge regarding their illness. In fact, the findings show how minority patients may be less likely than others to know and report accurate information about their tumors' characteristics.
The team, from the Wellcome Trust Sanger Institute and the University of Cambridge, identified the BCL11A gene as especially active in ‘triple negative’ breast cancer – an aggressive form of the disease accounting for about one in five cases.
"This study is a promising step forward" - Dr Emma Smith, Cancer Research UK
Welcoming the findings – based on an analysis of cancer samples from almost 3000 women - Dr Emma Smith, senior science information officer at Cancer Research UK, said: “Figuring out the genes that play a role in triple negative breast cancer could lead to new ways to tackle the disease - so this study is a promising step forward.
“The next steps will be finding out if the gene plays the same role in causing breast cancer in women, and whether drugs can be developed to target the faulty molecules," she added.
Breast cancer is now known to exist in 10 distinct subtypes based on tumours’ genetic make-up. Most triple-negative breast cancer tumours are of a genetic type called ‘basal-like’.
BCL11A was found to be overactive in tumour samples from around eight in 10 patients with ‘basal-like’ disease.
Prognosis for triple negative cancers is poorer than for other forms, and limited knowledge of the distinct genetic properties of the disease has made the development of new treatments difficult.
Therapies used in treating other subtypes – such as trastuzumab and tamoxifen – do not work on this type of cancer, because tumour cells lack three different ‘receptor’ molecules that are targeted by the treatments."
Hematology Oncology | The FDA today granted fast track status to sacituzumab govitecan, an antibody–drug conjugate in development for treatment of patients with triple-negative breast cancer who failed prior therapies for metastatic disease, according to the drug’s manufacturer.Sacituzumab govitecan (IMMU-132, Immunomedics) is formed by using the moderately-toxic SN-38 — the active metabolite of
"Five years of tamoxifen provided 20 years of breast cancer prevention to some at-risk women who took it prophylactically.
However, their 20-year all-cause mortality was no different from those taking placebo (182 vs. 166 deaths), nor was their mortality from breast cancer (31 vs. 26, respectively), Jack Cuzick, Ph.D., said at the San Antonio Breast Cancer Symposium.
“While we saw clear, lasting benefits of tamoxifen in reducing breast cancer incidence, uncertainty with respect to mortality remains,” said Dr. Cuzick, the John Snow professor of epidemiology at Wolfson Institute of Preventive Medicine at Queen Mary University, London.
He suggested that, in light of the small number of deaths, the study was not sufficiently powered to detect any significant survival difference. But women in the IBIS-1 trial will continue to be observed, and future analyses could clarify the issue, he added.
“Although 20 years seems like a long follow-up time, it is actually too early to make any clear statement about mortality,” he said. “However, we are concerned about an excess emergence of ER-negative tumors, which we saw after 10 years.”
'3 specific cells' combo behind breast cancer spread, confirm scientists - In a new study, scientists have found that it is the specific trio of cells that causes breast cancer to spread. A study, led by researchers at the NCI-designated Albert Einstein Cancer Center and Montefiore Einstein Center for Cancer Care, combining tumor cells from patients with breast cancer with a laboratory model of blood vessel lining provides the most compelling evidence so far, and the findings could lead to better tests for predicting whether a woman's breast cancer will spread and to new anti-cancer therapies.
"There exists a “type” of cancer that is common yet rarely discussed—metastatic disease, or cancer that has spread from the part of the body where it originated (the primary tumor) to another (such as lungs, bones or liver). Each year, at least 2.6 million people in the developed world die of cancers that have metastasized. Although much research is being done to combat primary tumors, there still exists a crucial need to find a treatment that can be effective against metastatic cancer, or “mets.”
Could a virus be the key to finally beating the mets? The question is not as odd as it might sound. Virotherapy or oncolytic virus therapy involves the conversion of viruses into cancer-fighting agents by reprogramming them to attack cancerous cells, while healthy cells remain relatively undamaged. Specifically, viruses can be harnessed to infect, multiply within and subsequently lyse cancer cells; the virus targets the tumor and protects normal tissue.
Several types of oncolytic viruses have been developed to date. One of them, the reovirus, is a non-enveloped virus with a double-stranded, segmented RNA genome that forms particles that are 60 to 90 nm. The reovirus preferentially replicates in cancer cells that feature a common mutation known as an “activated Ras pathway,” while sparing normal cells. This makes it intrinsically tumor selective without the need for any genetic manipulation."
I"I am dying, literally, at my home in Hollywood, of metastatic breast cancer, the only kind of breast cancer that kills. For six years I've known I was going to die. I just didn't know when.
Then, a couple of weeks before Christmas, a new, deadly diagnosis gave me a deadline. No doctor would promise me I'd make it to 2015.
Promise me, I told my friends and family, that you'll never say that I died after “fighting a courageous battle with breast cancer.” This tired, trite line dishonors the dead and the dying by suggesting that we, the victims, are responsible for our deaths or that the fight we were in was ever fair.
Promise me you'll never wear a pink ribbon in my name or drop a dollar into a bucket that goes to breast cancer “awareness” for “early detection for a cure,” the mantra of fund-raising juggernaut Susan G. Komen, which has propagated a distorted message about breast cancer and how to “cure” it.
I'm proof that early detection doesn't cure cancer. I had more than 20 mammograms, and none of them caught my disease. In fact, we now have significant studies showing that routine mammogram screening, which may result in misdiagnoses, unnecessary treatment and radiation overexposure, can harm more people than it helps...
Susan Zager's insight:
Laurie Becklund, a former Times staff writer, died Feb. 8. She wrote this over the past few months.
Laurie Becklund: 'Treat me like a statistic and save my life.'
(Reuters Health) – Among early-stage breast cancer patients in the U.S., black women are less likely than white women to take their prescribed hormone medications, according to a new study that partly - but not entirely - blames economic disparities between races.
MONTREAL, QUEBEC--(Marketwired - Feb. 17, 2015) - Alethia Biotherapeutics Inc., a privately held biotechnology company, announced today that it has submitted a Clinical Trial Application (CTA) with Health Canada to initiate a Phase I clinical trial with AB-16B5, a fully humanized monoclonal antibody that inhibits epithelial to mesenchymal transition (EMT)....
"Thank you for all of the wonderful responses we received about the Food and Drug Administration’s (FDA) approval of a drug for patients with advanced metastatic breast cancer. It's not always easy to decide which research has legs and is worth investing in— and I take that task seriously— but when something you believe in succeeds, the reward and sense of inspiration that follows can be immense. The FDA’s approval of Ibrance (palbociclib), a drug that the Noreen Fraser Foundation (NFF) helped fund the development for, did just that.
I have been fighting breast cancer for 13 years, and during that time I have done my homework. I have pored through research, and I have become familiar with the various institutions that are working in the breast cancer arena.
About halfway through this process, I concluded that a cure may never come. That realization can shock and shake a person up. But, in acknowledging that possibility, I concluded that finding a way to live with and contain cancer would be the next best step. Drugs like Ibrance have the potential to help breast cancer patients do that precisely. Sure, the drug isn't a cure, but targeted therapies like Ibrance can allow cancer to become a chronic disease like AIDS and diabetes— diseases you can live with and not die from.".
Susan Zager's insight:
Noreen Fraser is living with Stage IV metastatic breast cancer. She is the Founder and CEO of the Noreen Fraser Foundation, a 501(c)(3) non-profit organization dedicated to funding groundbreaking women's cancer research. Check out her web site at: http://www.noreenfraserfoundation.org/
My name is Ann Silberman. I have metastatic breast cancer - the only type of breast cancer that kills. Like 90 - 94% of people now living with Stage IV breast cancer, I was diagnosed with early stage disease. Although this was the year 2009, I did the same type of treatment that has been around for 30 years: slash, poison and burn. After my mastectomy and chemotherapy, I’d hoped to go back to a long, healthy life. Unfortunately, in 2011 breast cancer was found in my liver, and my disease is now incurable. The past four years have been a nightmare: chemo after chemo, surgeries and sepsis, radiation and sickness, scans and tests, hospitals and infusion rooms. Unlike most with a liver metastasis, I am lucky enough to still be alive 4 years later, although nobody can tell me for how long. Metastatic breast cancer has always been, and still is, incurable. Over the past 30 years, billions of dollars have been raised for the cause of breast cancer, with Komen being the most prominent non-profit involved. Every October, the US turns pink to support and raise funds to cure those with breast cancer. There isn't a large company in this country that doesn’t attach their name to a breast cancer charity. Most people who buy pink or run races believe that their money goes towards funding for a cure. They are misinformed. What does it take to cure cancer? Research and Innovation. It takes MDs and PhDs, laboratories and science, creativity, new technology, experiments to find new medications and treatments. Unfortunately, the vast majority of charitable funding goes towards the concept of “awareness.” And over the past generation, we have learned that being aware of cancer and discovering it early is no guarantee of safety; many women will end up with a metastasis no matter how early they found their cancer, even decades past their original diagnosis. I ask you, in 2014, who is not aware of breast cancer? As a former school secretary, I can tell you that even children understand what breast cancer is. Women of today are not fearful of speaking to their doctors, and mammographic screening is widespread. Awareness might have been paramount in the 1970s when women didn't discuss their breasts, but it is no longer necessary. Breasts are out and proud and women control their healthcare. The goal of awareness has been achieved. Has all this focus on awareness helped cure cancer? The number of deaths from breast cancer has hovered in the 40,000 range for the past 20 years. 25% to 30% of women diagnosed early stage will still progress to the metastatic, fatal stage. Study after study has highlighted the limits of breast cancer screening. The latest study, which was published in the British Medical Journal , was a 25-year analysis that concluded screening didn't decrease the risk of dying from cancer Scientists still do not understand fully the mechanism of metastasis, and how can one possibly cure cancer without funding to achieve this understanding? Finding breast cancer early is not a guarantee of safety. There are many gaps in our scientific understanding of this disease, and researchers and medical institutions are always in need of money, especially today. Government funding to the National Institutes of Health and other government agencies working on a cancer cure have been cut, and it is imperative that non-profits make up the difference. It is estimated that in the US, only 5% of funding for metastatic cancer goes towards metastatic research. In today’s society, it is shameful that an organization like Susan G Komen “for the cure” only spends 18% of their money on the one thing that has the potential cure breast cancer - and that is research. Pink drill bits won’t cure cancer. Football players in pink cleats won’t cure cancer. Pink soup cans won’t cure breast cancer. If these things cause donations to rise, than the money raised must go towards research - to cure cancer. I call on the Susan G. Komen Foundation for the Cure to live up to the “for the cure” part of its name and to change their funding model. I ask that Komen disclose exactly where their charitable donations are spent and commit at least 50% of total donations towards medical research. I ask every breast cancer awareness charity to do the same. I ask the public to hold them accountable. My goal was to live to see my son graduate from high school, and I am grateful that I was able to do that. I have a new goal, and that is to live to see a cure. I want my friends with metastatic cancer to live and raise their own children. It’s time to put down the pink flags, roll up the ribbons, and focus your dollars on research rather than awareness. If you do this, you will be saving sisters, mothers, daughters and wives. I will be speaking at SXSW 2015 along with Healthline to encourage this change in the flow of funding, and will be tweeting with the hasttag #BCcure. Please join me and let your voice be heard.
A breast cancer risk prediction model for African American women has been developed by scientists that found greater accuracy in predicting risk for the disease. The use of this model could result in increased eligibility of African Americans in breast cancer prevention trials.
For more information go to the study at: Molecular Breast Imaging (MBI) is a supplemental imaging technology designed to find tumors that would otherwise be obscured by surrounding dense breast tissue on a mammogram. The new breast imaging technique nearly quadruples detection rates of invasive breast cancers in women with dense breast tissue, according to the results of a major study.
Some of the most important advances in breast cancer this year were related to all kinds of heterogeneity: within tumors, between tumors in a single patient, and between tumors in early and later stages, according to oncologists speaking at conferences, and contacted by Bioscience Technology.
“This year we had a lot of fascinating stories,” Jorge Reis-Filho told the San Antonio Breast Cancer Symposium in December. Reis-Filho is a cancer geneticist at Memorial Sloan Kettering Cancer Center. Among the most important stories, he said, was the repeated confirmation, due to improving technology and massive genetics projects, that “heterogeneity is incredibly prevalent.”
Other areas of note, said oncologists, included findings that PALB2 is a strong germ-line proclivity gene; that drugs can be added to Herceptin to increase its potency; that ovarian suppression can work on some populations; and that long-term tamoxifen can prompt estrogen-induced apoptosis.
Daniel Hayes, a University of Michigan Cancer Center oncologist, told Bioscience Technology that one of the great papers of 2014 involved “identification of germ-line inherited mutations other than BRCA1 and 2 that increase susceptibility/risk for breast cancer.” The New England Journal of Medicine (NEJM)paper, by Addenbrooke’s Hospital’s Marc Tischkowitz, found that patients with a mutation in the PALB2 gene stand a one in three chance of getting breast cancer by age 70. The gene interacts with the deadly BRCA1 and BRCA2, and has been called the potential “BRCA3.”
"After making great strides for some patients with melanoma and lung cancer, immunotherapy drugs are starting to offer hope for women with a very challenging form of breast cancer—triple-negative breast cancer.
Data presented Dec. 10 at the San Antonio Breast Cancer Symposium showed that the PD-1 inhibitor pembrolizumab (Keytruda) was well tolerated by women with recurrent or metastatic triple-negative breast cancer and showed early signs of effectiveness. The PD-L1 inhibitor MPDL3280A was also found to be safe and tolerable for women with metastatic triple-negative breast cancer, with tumor shrinkage in some women.
This phase I, nonrandomized multicenter trial involved 32 patients from 29 to 72 years old who had heavily pretreated recurrent or metastatic triple-negative breast cancer. Patients received intravenous infusions of pembrolizumab every two weeks. Safety and tolerability of the drug—the standard endpoints of a phase I trial—were assessed, as well as antitumor activity."
Susan Zager's insight:
According to the article, "Triple-negative breast cancer is an area of active research,” says Nanda. “We are learning more about the different subtypes and are working hard to develop targeted approaches for patients with all forms of this disease. I would encourage patients with triple-negative breast cancer to consider enrolling in clinical trials if possible, so that together we can advance our understanding of these tumors and improve outcomes for women with this form of breast cancer.”
"Results from the final analysis of progression-free survival, response rate, and safety for the randomised, phase III Breast Cancer Trials of Oral Everolimus-1 (BOLERO-1) were presented at the 2014 San Antonio Breast Cancer Symposium.
“BOLERO-1 is a randomised, double-blind, phase III clinical trial evaluating whether the addition of everolimus, an mTOR inhibitor, to trastuzumab and paclitaxel improves progression- free survival for patients with HER2-positive, advanced breast cancer who have received no prior treatments for advanced disease,” said Sara A. Hurvitz, MD, an associate clinical professor of medicine and director of the Breast Oncology Program in the University of California, Los Angeles, Division of Haematology/Oncology.
“In San Antonio, we will be presenting data on progression-free survival for the overall patient population and in the subpopulation of patients with hormone receptor-negative disease,” continued Hurvitz. “We will also show our analysis of secondary endpoints of the study, including safety.”
"The trial will include breast cancer patients with low expression of HER2
Synthon Biopharmaceuticals (‘Synthon’) today announced that the first patients with metastatic solid tumors have commenced treatment with its investigational anti-HER2 antibody-drug conjugate (ADC), SYD985.
First patients for this trial are being enrolled in leading European oncology centers Radboud University Medical Center (Nijmegen, the Netherlands), the Jules Bordet Institute (Brussels, Belgium) and the Institute of Cancer Research at The Royal Marsden Hospital (London, United Kingdom). The trial will recruit at least 76 patients and more centers are expected to join the trial in 2015.
This trial is a two part first-in-human Phase I study. In the dose escalation part of the trial, safety and efficacy of SYD985 will be evaluated in patients with locally advanced or metastatic solid tumors of any origin. In the expanded cohort part of the trial, only patients with breast and gastric cancer will be enrolled. The expanded cohorts will include patients currently indicated for HER2-targeted treatment as well as patients with HER2 2+ and HER2 1+ breast cancer for whom there currently is no effective anti-HER2 therapy available."
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