Dr. Olwen Hahn, medical oncologist at the University of Chicago Department of Medicine, discusses recent developments in MBC research and treatment. Joining her is Dionna Koval, a metastatic breast cancer patient advocate.
Intermittent Fasting: How it Can Reduce the Risk of Breast Cancer Recurrencebkling
Breast cancer recurrence is the greatest fear for those with breast cancer. While many survivors know that being overweight can contribute to recurrence of their cancer, the thought of dieting and how to go about it can be overwhelming. Dr. Nicholas Webster, Professor of Medicine, Chief of the Division of Endocrinology and Metabolism, and Associate Director for Shared Resources, Moores Cancer Center discusses his study that suggests a path that is easy to follow and produces the type of results that can be a matter of life and death for some breast cancer patients.
Strategies for Managing Recurrent Ovarian Cancerbkling
When ovarian cancer returns, it's not uncommon to experience a range of emotions and feel overwhelmed. But it's important to remember that recurrent ovarian cancer can often be successfully treated. Dr. Shannon N. Westin, gynecologic oncologist and clinical investigator at MD Anderson Cancer Center, goes over the latest treatment options for recurrent disease.
The Changing Role of PARP Inhibitors in the Treatment of Ovarian Cancerbkling
In recent years, researchers have been looking into using a class of drugs called PARP inhibitors to prevent the progression and recurrence of ovarian cancer. Dr. Kathleen Moore of Stephenson Cancer Center, Principal Investigator of the SOLO-1 trial, explains how the results of this trial may affect ovarian cancer patients and where research on ovarian cancer treatment is headed next.
Report Back from SGO: What's the Latest in Ovarian Cancer?bkling
Dr. Joyce F. Liu, Director of Clinical Research for Gynecologic Oncology at Dana-Farber Cancer Institute, provides a comprehensive update from the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer.
Addressing your COVID-19 Breast Cancer Concerns bkling
Dr. Anne Moore, medical oncologist and Director of the Breast Cancer Survivorship Program at Weill Cornell and Dr. Leticia Varella, Assistant Professor of Medicine at Weill Cornell Medical College will go over changes in treatment and maintenance care for those with an early stage or metastatic breast cancer diagnosis. They will address your risk level as a cancer patient, provide strategies to minimize risk, discuss how to deal with anxiety, and answer your questions to help you through the COVID-19 pandemic.
Topic-Driven Round Table on Ovarian Cancer: Understanding Genetics and Ovaria...bkling
Women with ovarian cancer joined Julie Larson, LCSW, guest speaker Dr. Kathryn Pennington of UW Medicine, and peers via video or phone to discuss genetics and ovarian cancer.
Report Back from San Antonio Breast Cancer Symposium: Spotlight on MBCbkling
Dr. Virginia Kaklamani, Leader of the Breast Cancer Program at UT Health San Antonio MD Anderson Cancer Center, will share her biggest takeaways from the latest research presented at the San Antonio Breast Cancer Symposium (SABCS) 2019 with a focus on metastatic breast cancer.
Intermittent Fasting: How it Can Reduce the Risk of Breast Cancer Recurrencebkling
Breast cancer recurrence is the greatest fear for those with breast cancer. While many survivors know that being overweight can contribute to recurrence of their cancer, the thought of dieting and how to go about it can be overwhelming. Dr. Nicholas Webster, Professor of Medicine, Chief of the Division of Endocrinology and Metabolism, and Associate Director for Shared Resources, Moores Cancer Center discusses his study that suggests a path that is easy to follow and produces the type of results that can be a matter of life and death for some breast cancer patients.
Strategies for Managing Recurrent Ovarian Cancerbkling
When ovarian cancer returns, it's not uncommon to experience a range of emotions and feel overwhelmed. But it's important to remember that recurrent ovarian cancer can often be successfully treated. Dr. Shannon N. Westin, gynecologic oncologist and clinical investigator at MD Anderson Cancer Center, goes over the latest treatment options for recurrent disease.
The Changing Role of PARP Inhibitors in the Treatment of Ovarian Cancerbkling
In recent years, researchers have been looking into using a class of drugs called PARP inhibitors to prevent the progression and recurrence of ovarian cancer. Dr. Kathleen Moore of Stephenson Cancer Center, Principal Investigator of the SOLO-1 trial, explains how the results of this trial may affect ovarian cancer patients and where research on ovarian cancer treatment is headed next.
Report Back from SGO: What's the Latest in Ovarian Cancer?bkling
Dr. Joyce F. Liu, Director of Clinical Research for Gynecologic Oncology at Dana-Farber Cancer Institute, provides a comprehensive update from the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer.
Addressing your COVID-19 Breast Cancer Concerns bkling
Dr. Anne Moore, medical oncologist and Director of the Breast Cancer Survivorship Program at Weill Cornell and Dr. Leticia Varella, Assistant Professor of Medicine at Weill Cornell Medical College will go over changes in treatment and maintenance care for those with an early stage or metastatic breast cancer diagnosis. They will address your risk level as a cancer patient, provide strategies to minimize risk, discuss how to deal with anxiety, and answer your questions to help you through the COVID-19 pandemic.
Topic-Driven Round Table on Ovarian Cancer: Understanding Genetics and Ovaria...bkling
Women with ovarian cancer joined Julie Larson, LCSW, guest speaker Dr. Kathryn Pennington of UW Medicine, and peers via video or phone to discuss genetics and ovarian cancer.
Report Back from San Antonio Breast Cancer Symposium: Spotlight on MBCbkling
Dr. Virginia Kaklamani, Leader of the Breast Cancer Program at UT Health San Antonio MD Anderson Cancer Center, will share her biggest takeaways from the latest research presented at the San Antonio Breast Cancer Symposium (SABCS) 2019 with a focus on metastatic breast cancer.
Topic-Driven Round Table on Low Grade Serous Ovarian Cancerbkling
A discussion about low grade serous ovarian cancer with Dr. Amanda Nickles Fader, Director of Kelly Gynecologic Oncology Service, Johns Hopkins Hospital. This type of ovarian cancer behaves differently and is treated differently than other ovarian cancers. Join the conversation to learn more and ask an expert your questions.
Dr. Jennifer Mueller, gynecologic cancer surgeon at Memorial Sloan Kettering Cancer Center, will share research updates on uterine/endometrial cancer and other new developments in treatment and surgery.
New post-chemotherapy maintenance treatment options for ovarian cancer have emerged in recent years. Dr. Maurie Markman explains and takes questions on maintenance therapies for ovarian cancer in our 4th annual Joan Sommer Educational Program.
Join Dr. Kara Long Roche, Associate Director of the Gynecologic Oncology Fellowship Program at Memorial Sloan Kettering Cancer Center, as she breaks down new advancements in ovarian cancer research and treatment.
Metastatic Breast Cancer and The Tumor MicroenvironmentAmandaRussell40
This document summarizes research on how the tumor microenvironment influences metastasis at every step of the metastatic cascade. Key points include: (1) the microenvironment can suppress or promote tumorigenesis; (2) the perivascular niche protects disseminated tumor cells and keeps them dormant; (3) targeting the integrin receptors that mediate tumor cell interactions with the vascular niche can sensitize dormant tumor cells to chemotherapy and prevent metastasis without increasing toxicity.
Kimberly Halla, MSN, FNP-C, Paula J. Anastasia, RN, MN, AOCN, and Nelli Zafman, MSN, CRNP, AOCNP prepared useful Practice Aids pertaining to PARP inhibitor therapy for this CNE activity titled, "Realizing the Promise of PARP Inhibitors in Solid Tumor Therapy: Guiding Oncology Nurses on the Advances and Challenges." For the full presentation, monograph, complete CNE information, and to apply for credit, please visit us at http://bit.ly/2EkO5Ij. CNE credit will be available until May 22, 2020.
Report Back from SGO: What’s the Latest in Uterine Cancer?bkling
Dr. Jeannine Villella, Chief of Gynecologic Oncology at Lenox Hill Hospital, provides a comprehensive update from the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer. Dr. Villella breaks down what the research presented at the conference means for you and discusses new developments.
SHARE Ovarian Cancer RoundTable: Coping with Side Effects bkling
During SHARE's roundtable discussion for women with ovarian cancer, oncology nurse Heather Augustyniak provided tips that can help patients manage the side effects of treatment.
This document summarizes evidence on the role of surgery for metastatic breast cancer (MBC). It finds that palliative surgery effectively controls symptoms for MBC patients. Prospective studies also suggest surgery may improve survival for responsive MBC patients with a limited number of metastases, especially those with ER+ disease. However, randomized trials yield mixed results on survival benefits. While definitive local therapy may be justified for select asymptomatic MBC patients, systemic therapy and targeted therapies remain the top priority for these patients overall.
All in the Family: Hereditary Risk for Gynecologic Cancerbkling
Knowing and understanding your inherited genetics is important for ovarian and uterine cancer patients. Dr. Melissa Frey, gynecologic oncologist at Weill Cornell Medicine, discusses how genetic factors affect women with ovarian and uterine cancer and influence treatment decisions, with a particular focus on BRCA1 & 2 and Lynch Syndrome.
This webinar was being put on in partnership with FORCE.
Navigating Nutrition During Cancer and COVID-19bkling
Nutrition can be puzzling enough, but when you add a cancer diagnosis and a global pandemic, it’s even harder to make sense of it all. Julie Lanford, MPH, RD, CSO, LDN, "The Cancer Dietitian" for Cancer Services, will help put the pieces together so you’re equipped to navigate nutrition during cancer and COVID-19.
The document summarizes several international guidelines for treating breast cancer, including the St. Gallen, ASCO, NCCN, and AGO guidelines. The St. Gallen guidelines classify risk based on endocrine responsiveness. The NCCN guidelines recommend aromatase inhibitors for 5 years or switching from tamoxifen to an AI after 2-3 years. The ASCO guidelines also recommend aromatase inhibitors for 5 years or switching from tamoxifen to an AI after 2-5 years for no more than 5 years total on the AI.
Robert P. Edwards, MD, Chair of OB/GYN/RS, Co-Director of Women's Cancer Program at University of Pittsburgh, offers information about the current state of immunotherapy for recurrent ovarian cancer patients.
Black women experience higher rates of breast cancer and mortality compared to other groups in the US. Some factors that may contribute include less access to screening and treatment, as well as a higher frequency of more aggressive tumor subtypes like triple negative breast cancer. Research has found Black women are also more likely to be diagnosed with breast cancers that have exhausted immune cells surrounding the tumor. Factors like ancestry, a stronger pro-inflammatory response, lower breastfeeding rates, and lower vitamin D levels may all play a role in the increased aggressiveness seen in Black women's breast cancers. Ongoing research aims to better understand and address these disparities.
Uterine and endometrial cancer are the most common gynecologic cancers. Risk factors include obesity, tamoxifen use, and certain genetic conditions. Diagnosis involves endometrial biopsy. Treatment typically involves hysterectomy with or without radiation or chemotherapy depending on risk factors like tumor grade and stage. New immunotherapies are showing promise for recurrent or advanced disease. Precision medicine approaches are helping to classify subtypes and identify targeted therapies.
SHARE Webinar: Latest Research on Metastatic Breast Cancer from SABCS 2015bkling
Dr. Tiffany Traina, medical oncologist at Memorial Sloan-Kettering Cancer Center, presents the latest research on metastatic breast cancer reported at the San Antonio Breast Cancer Symposium in December 2015.
Triple Negative Breast Cancer and Women of Color (Slide 1)bkling
In this webinar, Dr. Onyinye D. Balogun and Dr. Lisa Newman of Weill Cornell Medicine-New York Presbyterian Hospital Network discuss all aspects of triple negative breast cancer and its impact on women of color in recognition of Black History Month.
This document discusses ovarian cancer research and clinical trials. It provides an overview of ovarian cancer subtypes and gene mutations associated with serous cancer. It also summarizes various drug targets and clinical trials being studied for ovarian cancer treatment, including PARP inhibitors, Akt inhibitors, angiogenesis inhibitors, monoclonal antibodies, immune therapies, vaccines, and CAR-T cells. Challenges in ovarian cancer research like intra-tumor variability and the complexity of genetics are discussed. The importance of patient participation in clinical trials to advance scientific progress is emphasized.
This document discusses a clinical trial evaluating the combination of ribociclib and endocrine therapy for pre/perimenopausal women with HR+, HER2- advanced breast cancer. The trial aimed to assess whether ribociclib plus an aromatase inhibitor and goserelin improved progression-free survival compared to placebo plus the same endocrine therapies. Key findings were that the combination led to a statistically significant improvement in progression-free survival. Overall survival data were also collected as a secondary outcome.
This document discusses sonographic criteria for uterine curettage when endometrial neoplasia is suspected. Eight premenopausal and perimenopausal women underwent transvaginal ultrasounds and uterine curettage due to abnormal bleeding or discharge. Histopathology found hyperplasia in polycystic ovary syndrome patients and cancer in a patient on tamoxifen therapy. Key ultrasound findings associated with hyperplasia or cancer included thick irregular endometrium, ill-defined endometrial-myometrial junction, intrauterine fluid collections, adnexal masses, and cystic endometrial areas. The document concludes that endometrial stripe abnormalities on ultrasound, in addition to thickness, are important
Report Back from San Antonio Breast Cancer Symposium (SABCS 2022)bkling
Curious about the latest developments in Early-Stage Breast Cancer and Metastatic Breast Cancer Research? Join us as Dr. Anne Blaes, the Division Director of Hematology/Oncology/Transplantation and Professor in Hematology/Oncology at the University of Minnesota, breaks down the most recent developments released at the annual San Antonio Breast Cancer Symposium regarding early-stage and metastatic breast cancer research.
Novel Strategies for Attacking the Epidermal Growth Factor ReceptorOSUCCC - James
Novel Strategies for Attacking the Epidermal Growth Factor Receptor
David Carbone, MD PhD
Director, James Thoracic Center
The Ohio State University
Columbus, OH USA
Topic-Driven Round Table on Low Grade Serous Ovarian Cancerbkling
A discussion about low grade serous ovarian cancer with Dr. Amanda Nickles Fader, Director of Kelly Gynecologic Oncology Service, Johns Hopkins Hospital. This type of ovarian cancer behaves differently and is treated differently than other ovarian cancers. Join the conversation to learn more and ask an expert your questions.
Dr. Jennifer Mueller, gynecologic cancer surgeon at Memorial Sloan Kettering Cancer Center, will share research updates on uterine/endometrial cancer and other new developments in treatment and surgery.
New post-chemotherapy maintenance treatment options for ovarian cancer have emerged in recent years. Dr. Maurie Markman explains and takes questions on maintenance therapies for ovarian cancer in our 4th annual Joan Sommer Educational Program.
Join Dr. Kara Long Roche, Associate Director of the Gynecologic Oncology Fellowship Program at Memorial Sloan Kettering Cancer Center, as she breaks down new advancements in ovarian cancer research and treatment.
Metastatic Breast Cancer and The Tumor MicroenvironmentAmandaRussell40
This document summarizes research on how the tumor microenvironment influences metastasis at every step of the metastatic cascade. Key points include: (1) the microenvironment can suppress or promote tumorigenesis; (2) the perivascular niche protects disseminated tumor cells and keeps them dormant; (3) targeting the integrin receptors that mediate tumor cell interactions with the vascular niche can sensitize dormant tumor cells to chemotherapy and prevent metastasis without increasing toxicity.
Kimberly Halla, MSN, FNP-C, Paula J. Anastasia, RN, MN, AOCN, and Nelli Zafman, MSN, CRNP, AOCNP prepared useful Practice Aids pertaining to PARP inhibitor therapy for this CNE activity titled, "Realizing the Promise of PARP Inhibitors in Solid Tumor Therapy: Guiding Oncology Nurses on the Advances and Challenges." For the full presentation, monograph, complete CNE information, and to apply for credit, please visit us at http://bit.ly/2EkO5Ij. CNE credit will be available until May 22, 2020.
Report Back from SGO: What’s the Latest in Uterine Cancer?bkling
Dr. Jeannine Villella, Chief of Gynecologic Oncology at Lenox Hill Hospital, provides a comprehensive update from the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer. Dr. Villella breaks down what the research presented at the conference means for you and discusses new developments.
SHARE Ovarian Cancer RoundTable: Coping with Side Effects bkling
During SHARE's roundtable discussion for women with ovarian cancer, oncology nurse Heather Augustyniak provided tips that can help patients manage the side effects of treatment.
This document summarizes evidence on the role of surgery for metastatic breast cancer (MBC). It finds that palliative surgery effectively controls symptoms for MBC patients. Prospective studies also suggest surgery may improve survival for responsive MBC patients with a limited number of metastases, especially those with ER+ disease. However, randomized trials yield mixed results on survival benefits. While definitive local therapy may be justified for select asymptomatic MBC patients, systemic therapy and targeted therapies remain the top priority for these patients overall.
All in the Family: Hereditary Risk for Gynecologic Cancerbkling
Knowing and understanding your inherited genetics is important for ovarian and uterine cancer patients. Dr. Melissa Frey, gynecologic oncologist at Weill Cornell Medicine, discusses how genetic factors affect women with ovarian and uterine cancer and influence treatment decisions, with a particular focus on BRCA1 & 2 and Lynch Syndrome.
This webinar was being put on in partnership with FORCE.
Navigating Nutrition During Cancer and COVID-19bkling
Nutrition can be puzzling enough, but when you add a cancer diagnosis and a global pandemic, it’s even harder to make sense of it all. Julie Lanford, MPH, RD, CSO, LDN, "The Cancer Dietitian" for Cancer Services, will help put the pieces together so you’re equipped to navigate nutrition during cancer and COVID-19.
The document summarizes several international guidelines for treating breast cancer, including the St. Gallen, ASCO, NCCN, and AGO guidelines. The St. Gallen guidelines classify risk based on endocrine responsiveness. The NCCN guidelines recommend aromatase inhibitors for 5 years or switching from tamoxifen to an AI after 2-3 years. The ASCO guidelines also recommend aromatase inhibitors for 5 years or switching from tamoxifen to an AI after 2-5 years for no more than 5 years total on the AI.
Robert P. Edwards, MD, Chair of OB/GYN/RS, Co-Director of Women's Cancer Program at University of Pittsburgh, offers information about the current state of immunotherapy for recurrent ovarian cancer patients.
Black women experience higher rates of breast cancer and mortality compared to other groups in the US. Some factors that may contribute include less access to screening and treatment, as well as a higher frequency of more aggressive tumor subtypes like triple negative breast cancer. Research has found Black women are also more likely to be diagnosed with breast cancers that have exhausted immune cells surrounding the tumor. Factors like ancestry, a stronger pro-inflammatory response, lower breastfeeding rates, and lower vitamin D levels may all play a role in the increased aggressiveness seen in Black women's breast cancers. Ongoing research aims to better understand and address these disparities.
Uterine and endometrial cancer are the most common gynecologic cancers. Risk factors include obesity, tamoxifen use, and certain genetic conditions. Diagnosis involves endometrial biopsy. Treatment typically involves hysterectomy with or without radiation or chemotherapy depending on risk factors like tumor grade and stage. New immunotherapies are showing promise for recurrent or advanced disease. Precision medicine approaches are helping to classify subtypes and identify targeted therapies.
SHARE Webinar: Latest Research on Metastatic Breast Cancer from SABCS 2015bkling
Dr. Tiffany Traina, medical oncologist at Memorial Sloan-Kettering Cancer Center, presents the latest research on metastatic breast cancer reported at the San Antonio Breast Cancer Symposium in December 2015.
Triple Negative Breast Cancer and Women of Color (Slide 1)bkling
In this webinar, Dr. Onyinye D. Balogun and Dr. Lisa Newman of Weill Cornell Medicine-New York Presbyterian Hospital Network discuss all aspects of triple negative breast cancer and its impact on women of color in recognition of Black History Month.
This document discusses ovarian cancer research and clinical trials. It provides an overview of ovarian cancer subtypes and gene mutations associated with serous cancer. It also summarizes various drug targets and clinical trials being studied for ovarian cancer treatment, including PARP inhibitors, Akt inhibitors, angiogenesis inhibitors, monoclonal antibodies, immune therapies, vaccines, and CAR-T cells. Challenges in ovarian cancer research like intra-tumor variability and the complexity of genetics are discussed. The importance of patient participation in clinical trials to advance scientific progress is emphasized.
This document discusses a clinical trial evaluating the combination of ribociclib and endocrine therapy for pre/perimenopausal women with HR+, HER2- advanced breast cancer. The trial aimed to assess whether ribociclib plus an aromatase inhibitor and goserelin improved progression-free survival compared to placebo plus the same endocrine therapies. Key findings were that the combination led to a statistically significant improvement in progression-free survival. Overall survival data were also collected as a secondary outcome.
This document discusses sonographic criteria for uterine curettage when endometrial neoplasia is suspected. Eight premenopausal and perimenopausal women underwent transvaginal ultrasounds and uterine curettage due to abnormal bleeding or discharge. Histopathology found hyperplasia in polycystic ovary syndrome patients and cancer in a patient on tamoxifen therapy. Key ultrasound findings associated with hyperplasia or cancer included thick irregular endometrium, ill-defined endometrial-myometrial junction, intrauterine fluid collections, adnexal masses, and cystic endometrial areas. The document concludes that endometrial stripe abnormalities on ultrasound, in addition to thickness, are important
Report Back from San Antonio Breast Cancer Symposium (SABCS 2022)bkling
Curious about the latest developments in Early-Stage Breast Cancer and Metastatic Breast Cancer Research? Join us as Dr. Anne Blaes, the Division Director of Hematology/Oncology/Transplantation and Professor in Hematology/Oncology at the University of Minnesota, breaks down the most recent developments released at the annual San Antonio Breast Cancer Symposium regarding early-stage and metastatic breast cancer research.
Novel Strategies for Attacking the Epidermal Growth Factor ReceptorOSUCCC - James
Novel Strategies for Attacking the Epidermal Growth Factor Receptor
David Carbone, MD PhD
Director, James Thoracic Center
The Ohio State University
Columbus, OH USA
Palbociclib in Metastatic Breast CancerVibhay Pareek
1) The document discusses the role of palbociclib, a CDK4/6 inhibitor, in the treatment of metastatic breast cancer.
2) Key clinical trials showed that combining palbociclib with an aromatase inhibitor significantly improved progression-free survival compared to an aromatase inhibitor alone.
3) The BOLERO-2 trial found that adding everolimus, an mTOR inhibitor, to exemestane improved progression-free survival by 5 months and overall survival by 6 months compared to exemestane alone in metastatic breast cancer.
1) The document discusses antibody-drug conjugates (ADCs) for the treatment of HER2-positive breast cancer, including FDA-approved ADCs Kadcyla (ado-trastuzumab emtansine), Enhertu (fam-trastuzumab deruxtecan), and Trodelvy (sacituzumab govitecan).
2) Clinical trial results showed that adding pertuzumab or neratinib to standard chemotherapy and trastuzumab improved outcomes for patients with early-stage HER2-positive breast cancer.
3) The KATHERINE trial found that for patients with residual disease after neoadjuvant therapy, T-DM1 led
Triple-negative breast cancer (TNBC) lacks estrogen, progesterone, and HER2 receptors. It represents 15% of breast cancers and has a higher sensitivity to chemotherapy than other subtypes. New targeted therapies are being developed and tested in clinical trials based on TNBC's defective DNA repair pathways. These include PARP inhibitors, platinum chemotherapy, and angiogenesis inhibitors. TNBC is a heterogeneous disease with multiple molecular subtypes, each with different treatment responses. Participation in clinical trials is important to advance new targeted therapies for TNBC.
What's the latest in breast cancer treatment and research? Erica Mayer, MD, MPH, a medical oncologist in the Susan F. Smith Center for Women's Cancers, shares the latest breast cancer news.
This presentation was originally given on Oct. 16, 2015, at the annual Young Women with Breast Cancer Forum, hosted by the Program for Young Women with Breast Cancer in the Susan F. Smith Center for Women's Cancers at Dana-Farber Cancer Institute, in Boston, Mass.
Learn more: http://www.susanfsmith.org
This document summarizes recent advances in treating triple negative breast cancer (TNBC). TNBC accounts for 15-20% of breast cancers and has a poorer prognosis than other subtypes. New classifications identify basal-like and other subtypes. Standard chemotherapy remains the first-line treatment for early and advanced TNBC, but adding platinum agents or nab-paclitaxel to neoadjuvant chemotherapy improves outcomes. PARP inhibitors such as olaparib and talazoparib improve progression-free survival in BRCA-mutated metastatic TNBC. Immunotherapy with atezolizumab, pembrolizumab or combinations improves progression-free and overall survival in PD-L1 positive advanced
Colorectal Cancer Research & Treatment News - recap from the May 2014 ASCO co...Fight Colorectal Cancer
This document summarizes key findings from the PRIME trial evaluating the addition of panitumumab to FOLFOX4 as first-line treatment for metastatic colorectal cancer. Biomarker analysis found that KRAS exon 2 wild-type tumors derived greater benefit from the addition of panitumumab, with a progression-free survival advantage compared to FOLFOX4 alone. Further biomarker testing found mutations in other RAS isoforms or BRAF reduced likelihood of benefit from panitumumab. The results support use of RAS/BRAF mutation testing to select patients for first-line anti-EGFR therapy in combination with chemotherapy.
Analyzing ASCO 2016: Developments, takeaways, and implications from the confe...Pharma Intelligence
In conjunction with a Key Opinion Leader, Dr. Peter Lee MD Chair, Department of Immuno-Oncology at City of Hope Comprehensive Cancer Center, CA, several Informa analysts discuss the major developments of the conference and key take-aways via a Webinar.
Watch our recording of Biomedtracker's Robert Jeng, Ph,D., Citeline's Allison Bruce, Scrip's Mary Jo Laffler, and Datamonitor Healthcare's Zachary McLellan as they download and debrief following the always-exciting ASCO weekend.
View and listen to the full webinar here https://www.youtube.com/watch?v=7yMsCb3R5X8
What’s the Latest in Clear Cell Ovarian Cancer?bkling
The understanding of clear cell ovarian cancer is evolving. If you’re diagnosed with clear cell ovarian cancer and eager for information specific to your subtype, we’ve got you covered! Join Dr. Jubilee Brown, Professor and Director of Gynecologic Oncology at Levine Cancer Institute, as she discusses current treatment options and any promising advances. Come with your questions and leave more informed about your subtype.
Report Back from San Antonio Breast Cancer Symposium (SABCS) 2023: Spotlight ...bkling
We are thrilled to have Dr. Timothy Pluard, director of the Saint Luke’s Koontz Center for Advanced Breast Cancer, explain the recent research released at the annual San Antonio Breast Cancer Symposium (SABCS), 2023. Join us to gain a better understanding of what all the new data means to you and hear the answers to questions you may have.
What are the latest treatment advances for HER2-positive metastatic breast cancer? Eric Winer, MD, director of the Breast Cancer Program in the Susan F. Smith Center for Women's Cancers, discusses some of the latest research and treatment options.
This presentation was originally given as part of the 2015 Metastatic Breast Cancer Forum, held on October 17 at Dana-Farber Cancer Institute in Boston, Mass.
For more information, visit www.susanfsmith.org
The document discusses four major clinical trials investigating the use of Herceptin (trastuzumab) in the adjuvant setting for HER2-positive breast cancer: HERA, NSABP B-31, Intergroup N9831, and BCIRG 006. The HERA trial is randomly assigning over 3,000 patients to 1 or 2 years of Herceptin or observation after standard adjuvant therapy. The other trials are comparing Herceptin-containing regimens to standard chemotherapy alone. The goals are to establish Herceptin's efficacy, safety, and optimal duration in early-stage disease.
Breast Cancer Treatment: Where we are, Where we're going - April 24th, 2018Summit Health
This document summarizes a presentation on breast cancer treatment. It discusses:
1) The current state of breast cancer treatment including molecular classification, adjuvant therapies, neoadjuvant therapies, and treatments for metastatic disease.
2) Surgical options for breast cancer including lumpectomy, mastectomy, and breast reconstruction techniques.
3) Radiation therapy techniques including reducing heart dose using deep inspiration breath hold and shorter treatment schedules.
1) Targeted kinase inhibitors such as sorafenib show promise in treating radioactive iodine refractory thyroid cancer, with sorafenib demonstrating a partial response rate of 36% and clinical benefit in 82% of patients in one study.
2) Management of radioactive iodine refractory thyroid cancer involves local therapies when possible and enrollment in clinical trials of small molecule tyrosine kinase inhibitors like sorafenib, which target pathways important in thyroid cancer signaling and growth.
3) Guidelines recommend targeted kinase inhibitors as first-line treatment for radioactive iodine refractory thyroid cancer based on their improved efficacy over chemotherapy and ability to potentially prolong progression-free and overall survival.
Learn about the latest treatment options for advanced triple-negative breast cancer. Nancy Lin, MD, a breast oncologist in the Susan F. Smith Center for Women's Cancers at Dana-Farber, discusses new research.
This presentation was originally given as part of the 2015 Metastatic Breast Cancer Forum, held at Dana-Farber Cancer Institute in Boston, Mass. on Oct. 17, 2015.
More information is available at http://www.susanfsmith.org.
Optimizing the Management of Metastatic TNBC: Diagnostics, Treatments and Hop...bkling
The treatment for mTNBC is evolving with the identification of biomarkers and clinical trials revealing new treatment options. Join us to hear from our expert guests, Dr. Paolo Tarantino, an advanced research fellow at Dana-Farber Cancer Institute and at Harvard Medical School, and Dr. Ana Garrido-Castro, Breast Medical Oncologist at Dana-Farber Cancer Institute (DFCI) and Assistant Professor of Medicine at Harvard Medical School.They will present the important changes in genetic/ biomarker diagnostics, immunotherapy as well as emerging therapies. This presentation will also highlight racial disparities and how TNBC disproportionately affects the Black community. Register now and discover your clinical options. Feel free to bring any questions you may have for discussion after the presentation.
The Importance of Black Women Understanding the Chemicals in Their Personal C...bkling
Certain chemicals, such as phthalates and parabens, can disrupt the body's hormones and have significant effects on health. According to data, hormone-related health issues such as uterine fibroids, infertility, early puberty and more aggressive forms of breast and endometrial cancers disproportionately affect Black women. Our guest speaker, Jasmine A. McDonald, PhD, an Assistant Professor in the Department of Epidemiology at Columbia University in New York City, discusses the scientific reasons why Black women should pay attention to specific chemicals in their personal care products, like hair care, and ways to minimize their exposure.
Let's Talk About It: Breast Cancer (Survivor’s Guilt)bkling
The question of “Why me?” often exemplifies the experience of survivor’s guilt. Feeling survivor’s guilt is more common than you may think and can be triggered in different ways. Your positive news at a follow-up visit, regaining strength when treatment ends and manageable side effects are all events that may counter-intuitively lead to stress or even shame. Feeling the sting of hurt when others share good news and you feel the anguish of your losses, by comparison, can be hard to acknowledge and know how to manage. The loss of a fellow survivor naturally gives rise to grief which can be compounded by guilt. Let’s Talk About It.
MBC Support Group for Black Women – Insights in Genetic Testing.pdfbkling
Christina Spears, breast cancer genetic counselor at the Ohio State University Comprehensive Cancer Center, joined us for the MBC Support Group for Black Women to discuss the importance of genetic testing in communities of color and answer pressing questions.
Let's Talk About It: Breast Cancer (What is Mindset and Does it Really Matter?)bkling
Your mindset is the way you make sense of the world around you. This lens influences the way you think, the way you feel, and how you might behave in certain situations. Let's talk about mindset myths that can get us into trouble and ways to cultivate a mindset to support your cancer survivorship in authentic ways. Let’s Talk About It!
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Let's Talk About It: Ovarian Cancer (The Emotional Toll of Treatment Decision...bkling
Making treatment decisions is stressful. The work of understanding complex medical information, crafting questions for your medical team, and trusting oneself is hard. We break down this intense time in ways that might feel more manageable and help you regain a sense of calm as you work hard to care for yourself at each turn in the road. Let’s talk about it.
Report Back from SGO: What’s the Latest in Ovarian Cancer?bkling
Are you curious about what’s new in ovarian cancer research or unsure what the findings mean? Join Dr. Elena Pereira, a gynecologic oncologist at Lenox Hill Hospital, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Pereira will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Part I - Anticipatory Grief: Experiencing grief before the loss has happenedbkling
Anticipatory grief is the emotional experience when there is an impending loss that will occur. Often, people associate loss and grief with death, this is just one area in which grief and loss can occur. Anticipatory grief is often a slower grieving process marked by intermittent, small or large losses. In the world of cancer, anticipatory grief may show up in a variety of ways, such as before a major surgery, losing hair from chemotherapy treatment or caring for a loved one with advanced cancer.
Learn about anticipatory grief and ways to cope with it. We will also explore methods to heal from this challenging experience.
See it and Catch it! Recognizing the Thought Traps that Negatively Impact How...bkling
A cancer diagnosis is stressful. Feelings of worry, fear, self-doubt, sadness, and loneliness are normal but can feel exhausting and consuming at times. Cultivating a habit of thought-watching and learning to recognize thought traps that might be contributing to our discomfort can help us respond and care for ourselves in helpful ways. Learn more about the connection between what we think and how we feel and what you can do about it that might impact how you feel today. Let’s talk about it.
Advocating for Better Outcomes: Ovarian Cancer and Youbkling
Many parts of your life can affect your health and your cancer risk. Things like your race, ethnicity, where you live, and your finances matter. Even so, how can you get the health care you need and lower your cancer risk? What should you and your family do if you need to speak up?
Join this special talk about knowing your risk, ovarian cancer care, and ways we can speak up to improve our health. provided by two experts from Memorial Sloan Kettering Cancer Center (MSK) and SHARE.
Do you want to feel empowered and confident in preserving your independence and lowering your risk for injury? Learn how to reduce the risk of injury, how to fall safely, and maximize quality of life. Avoid common pitfalls and connect with others who share this concern!
Speakers: Ayden Jones, Falls Prevention Consultant and A Matter of Balance Master Trainer, and Janvier Hoist-Forrester, OTS.
Embracing Life's Balancing Act: Part 2 - Fall Action Planbkling
Do you want to feel empowered and confident in preserving your independence and lowering your risk for injury? Learn how to reduce the risk of injury, how to fall safely, and maximize quality of life. Avoid common pitfalls and connect with others who share this concern!
Speakers: Ayden Jones, Falls Prevention Consultant and A Matter of Balance Master Trainer, and Janvier Hoist-Forrester, OTS.
Let's Talk About It: Communication, Intimacy, and Sex… Oh My!bkling
Changes to your body are normal to experience related to a cancer diagnosis. But the grief and the learning to live with a changed body take time. But what if you share your body with someone else? What if finding pleasure and connection through intimacy feels like an overwhelming or insurmountable obstacle on your road to healing? Let's talk together about our personal experiences and questions surrounding this important topic of communication and intimacy.
Let's Talk About It: To Disclose or Not to Disclose?bkling
Sharing your cancer diagnosis with others can bring up a range of unexpected feelings and questions. Deciding who you tell, how much to share, and why are all important things to consider. The answer to these questions is personal and it varies not only between survivors but also in different settings and relationships in your life. We talk together about personal experiences and questions surrounding this important topic.
Report Back from SGO: What’s New in Uterine Cancer?.pptxbkling
Dr. Ebony Hoskins, gynecologic oncologist at MedStar Washington Hospital Center, provides a comprehensive update from the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer. Dr. Hoskins breaks down the research presented at the conference, discusses new developments, and addresses the most pressing questions.
Learn Tips for Managing Chemobrain or Mental Fogginessbkling
Chemobrain, or mental fogginess, is experienced by many patients during and after cancer treatment. But what are some strategies that help?Dennis Lin, OTD, OTR/L, Occupational Therapist at City of Hope National Medical Center, will provide tips on how you can manage chemobrain and support better engagement in your daily life.
Vaccines: Will they become a form of Secondary and Primary Breast Cancer Prev...bkling
Our guest speaker Lee Gravatt Wilke, MD, Senior Medical Director at the University of Wisconsin School of Medicine and Public Health, explains the current state of vaccine clinical trials in breast cancer followed by a review of the STEMVAC trial, design of the vaccine, and the current state of the accrual and next steps.
Let's Talk About It: Uterine Cancer (Advance Care Planning)bkling
Although it can be a difficult topic, advance care planning is very important for anyone facing a cancer diagnosis. The goal of advance care planning is to set up a plan to make sure you get the care you want in the future. It is critical to prepare for future decisions about your medical care with your family and support system. We discuss how to start and continue those important conversations. Learn about the differences between palliative care and hospice, when to bring up your wishes with your medical team, and how to prepare your family for navigating these decisions.
Moving Forward After Uterine Cancer Treatment: Surveillance Strategies, Testi...bkling
You’ve been treated for uterine cancer. Now what? With surveillance strategies varying from doctor to doctor, it can be hard to know which advice you should follow. Dr. Jennifer Mueller, Head of the Endometrial Cancer Section, Gynecologic Oncology Service at Memorial Sloan Kettering Cancer Center, delves into surveillance guidelines, which tests to consider, and how to keep an eye out for any symptoms which could indicate recurrence.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
1. Metastatic Breast Cancer:
Select Updates
Olwen Hahn, MD
Associate Professor of Medicine
The University of Chicago
Dionna Koval
Patient Advocate
June 2020
2. Outline
• Her2- Positive Breast Cancer
• Triple Negative Breast Cancer
• ER+ Breast Cancer
• Surgery in deNovo Mets. BrCa
• Patient – Doctor Communication
3. Normal
Overexpressed HER2
Excessive cellular division
HER2 Signals Cells to Divide
Berger et al. Cancer Res. 1988;48:1238.
Roskoski. Biochem Biophys Res Commun. 2004;319:1.
Rowinsky. Annu Rev Med. 2004;55:433.
Slamon et al. Science. 1987;235:177.
HER2 is overexpressed in
~20-25% of breast cancers
4. HER2-Positive Breast Cancer
Slamon et al. Science. 1987;235:177.
Months
0
12 24 36 48 60 72 84
Disease-freesurvivalprobability
Not amplified (n=52)
Amplified (n=11)
>5 copies
0
P=0.015
0.2
0.4
0.6
0.8
1.0
5. • Targets HER2 receptor
protein, which occurs in 20%
to 25% of patients with
breast cancer
• High affinity (Kd = 5nM) and
specificity
• 95% human, 5% murine
– Decreased potential for
immunogenicity
– Increased potential for
recruiting immune effector
mechanisms
Carter et al, 1992; Park et al, 1993;
Slamon et al, 1987; Genentech, data on file
Trastuzumab: Humanized Anti-HER2 Antibody
6. 7 FDA-Approved HER2-Targeted Agents for MBC
T-DM1, trastuzumab emtansine.
Adapted from Gajria D, et al. Expert Rev Anticancer Ther. 2011;11:263-275.
T-DxD
neratinib
HER2
HER2 HER2
tucatinib
7. Current Approach for Sequencing Therapy:
Advanced HER2+ Breast Cancer
First Line1
• Trastuzumab +
Pertuzumab +
Taxane
Third Line and
Beyond1
• Lapatinib + Capecitabine
• CT + Trastuzumab
– Eribulin, vinorelbine,
gemcitabine,
capecitabine, CMF
• Lapatinib + Trastuzumab
• Hormonal therapy +
Anti-HER2 (for HR+)
• Trastuzumab/Pertuzumab or
T-DM1, if not received prior
• T-DXd (DS-8201)
• Neratinib/Capecitabine
• Tucatinib/Capecitabine/
• Trastuzumab
Second Line1
• T-DM1
• Tucatinib +
Capecitabine +
Trastuzumab**
1. Giordano SH, et al. J Clin Oncol. 2018;36(26):2736-2740; 2. NCCN. Breast Cancer. V2.2020. Feb 5, 2020.
9. Doi T, et al. J Clin Oncol. 2017;35(suppl):abstract 108..
Fam-trastuzumab Deruxtecan
Structure and Mechanism of Action
Designed with the goal of improving clinical attributes of an ADC
10. DESTINY-BREAST01: Open-Label, Phase II Study of T-DXd
Baseline Characteristics of Note
• 53% HR+
• HER2 IHC 3+ 84%; 1+/2+ (FISH+) 16%
• 92% visceral disease; 13% h/o brain metastases
• Median 6 prior lines of therapy (range, 2–27)
Population
• ≥18 years of age
• Unresectable and/or
metastatic BC
• HER2+ (centrally confirmed
on archival tissue)
• Prior T-DM1
• Excluded patients with
history of significant ILD
• Stable, treated brain
metastases were allowed
T-DM1
resistant/refractory
(n = 249)
R
1:1:1
PK Stage
(n = 65)
PART 1
6.4 mg/kg
(n=22)
7.4 mg/kg
(n=21)
5.4 mg/kg
(n=22)
PART 2
Continuation Stage
(n = 134)
PART 2a
5.4 mg/kg
(n=130)
T-DM1
intolerant
(n = 4)
PART 2b
5.4 mg/kg
(n=4)
Dose-Finding Stage
(n = 54)
R
1:1
5.4 mg/kg
(n=28)
6.4 mg/kg
(n=26)
PART 2a
5.4 mg/kg
(n=130)
PART 2b
5.4 mg/kg
(n=4)
5.4 mg/kg
(n=22)
5.4 mg/kg
(n=28)
184 patients
enrolled at 5.4 mg/kg
11. Modi S, et al. N Engl J Med. 2019;382(7):610-621.
DESTINY-BREAST01: T-DXd Tumor Response
ORR: 60.9%
Complete response rate: 6%
Duration of response: 14.8 mo
12. DESTINY-BREAST01: T-DXd Progression-Free Survival
Median PFS: 16.4 months (95% CI: 12.7, NE)
Median PFS in 24 pts with CNS mets: 18.1 mo (95% CI: 6.7, 18.1)
(Median OS not reached)
Modi S, et al. N Engl J Med. 2019;382(7):610-621.
13. DESTINY-BREAST01 T-DXd: Treatment-Emergent Adverse
Events in >15% of Patientsa
0 20 40 60 80 100
Cough
Headache
Thrombocytopenia
Decreased WBC Count
Diarrhea
Anemia
Decreased Appetite
Neutropenia
Constipation
Vomiting
Alopecia
Fatigue
Nausea
Any TEAE
Grade 1 or 2
Grade ≥3
• Serious TEAEs, 22.8% (drug related, 12.5%)
• TEAEs associated with discontinuation, 15.2% (drug related, 14.7%); majority were due to pneumonitis/ILD (8.7%)
• 9 (4.9%) TEAE-associated deathsb
Patients who received T-DXd 5.4 mg/kg (N = 184)
Preferred
Term, n (%)
Grade
1
Grade
2
Grade
3
Grade
4
Grade
5
Any
Grade/
Total
Interstitial
lung diseasea 5 (2.7) 15 (8.2) 1 (0.5) 0 4 (2.2) 25 (13.6)
Interstitial Lung Disease
Median time from the first infusion of T-DXd to
onset of ILD was 27.6 weeks (range, 6–76 weeks)
Modi S, et al. N Engl J Med. 2019;382(7):610-621.
14. FDA Accelerated Approval 12.20.2019
Fam-trastuzumab deruxtecan-nxki approved for
patients with unresectable or metastatic HER2+
breast cancer who have received 2 or more prior
anti-HER2–based regimens in the metastatic
setting.
15. Breast cancer and Brain Metastases
Presented By Erika Hamilton at TBD
16. Challenges of Systemic Therapy
• Blood-brain barrier
• Limited number of prospective trials
• Many underpowered studies
• Many reports include a variety of tumors
• Most patients with brain metastases have progressed on
several therapies
20. OS Benefit in Brain Metastases
Presented By Erika Hamilton at TBD
21. FDA Approval 4.17.2020
Tucatinib approved in combination with
trastuzumab and capecitabine, for adult
patients with advanced unresectable or
metastatic HER2+ breast cancer,
including patients with brain
metastases, who have received 1 or more
prior anti-HER2–based regimens in the
metastatic setting.
24. Triple-negative Breast Cancer (TNBC)
• TNBC lacks estrogen and progesterone hormone receptors (ER
and PR), and does not exhibit overexpression of human
epidermal growth factor receptor 2 (HER2)
• TNBC accounts for ~15% of breast cancers
• More common in
• Young women
• Individuals of African and Hispanic heritage
• BRCA1 germline mutations
• Poorer overall survival vs other forms of breast cancer
• Historically, limited treatment options
Saha P, Nanda R. Ther Adv Med Oncol. 2016; Marra A, et al. BMC Med. 2019;
Schmid P, et al. N Engl J Med. 2018; Jia H, et al. Drug Resist Updat. 2017; Lebert JM, et al. Curr Oncol. 2018.
All Breast
Cancers
ER+
65%–75%
HER2+
15%–20%
Triple
negative
15%
25. The Current Paradigm: Metastatic Treatment
HER2-Negative*
Preferred Regimens
• Anthracyclines
• Doxorubicin
• Liposomal doxorubicin
• Taxanes
• Paclitaxel
• Anti-metabolites
• Capecitabine
• Gemcitabine
• Microtubule inhibitors
• Vinorelbine
• Eribulin
• For germline BRCA1/2 mutations see additional targeted therapy options (BINV-R)
• Platinum (option for patients with triple-negative tumors and germline BRCA1/2
mutation)
• Carboplatin
• Cisplatin
• For PD-L1–positive TNBC see additional targeted therapy options (BINV-R)e
Other Recommended Regimens
• Cyclophosphamide
• Docetaxel
• Albumin-bound paclitaxel
• Epirubicin
• Ixabepilone
Useful in Certain Circumstances
• AC (doxorubicin/cyclophosphamide)
• EC (epirubicin/cyclophosphamide)
• CMF (cyclophosphamide/methotrexate/fluorouracil)
• Docetaxel/capecitabine
• GT (gemcitabine/paclitaxel)
• Gemcitabine/carboplatin
• Paclitaxel/bevacizumab
• Carboplatin + paclitaxel or albumin-bound paclitaxel
NCCN Guidelines. Breast Cancer. v3.2020.*All recommendations are category 2A unless otherwise noted.
31. Sacituzumab Govitecan: An ADC Targeting Trop2
Bardia A, et al. N Engl J Med. 2019;380(8):741-751.
Other ADCs being investigated in TNBC
-Ladiratuzumab (LIV1A)
-Trastuzumab deruxtecan (HER2 1-2+)
32. Drugs in Development for Advanced TNBC
• Immunotherapy
– With chemo and other targeted therapies
• PARP Inhibitors (approved for BRCA1&2 mutation carriers
alone)
– Alone or with chemo or immunotherapy
• Antibody Drug Conjugates
– Sacituzumab approved, others being investigated
• Androgen Receptor Antagonists
34. Treatment of ER+ MBC
• First line therapy with cdk 4/6 inhibitor + endocrine backbone
(aromatase inhibitor) is current standard for most patients
• 3 approved cdk 4/6 inhibitors:
– Palbocliclib, Ribocliclib, Abemacliclib
• In 2019: Alpelisib was recently FDA approved (+fulvestrant)
for pts with PIK3C mutations
– SOLAR study – most patients received endocrine therapy alone
35. CDK 4/6i + AI: 1L therapy for HR+/HER2- MBC
Presented By Erika Hamilton at TBD
45. Should Treatment of De novo Metastatic Breast Cancer (MBC) include Local Regional Therapy for the Primary?
Presented By Julia White at TBD
46. Completed randomized trials testing the value of LRT in de novo Stage IV breast cancer have provided conflicting data
Presented By Seema Khan at TBD
47. Design of E2108 <br />Opened in 2011, last patient enrolled in 2015. <br />
Presented By Seema Khan at TBD
48. No Improvement in Survival from Early Local Therapy<br />E2108
Presented By Julia White at TBD
49. Summary: De novo Stage IV Breast Cancer
Presented By Julia White at TBD
51. Discussing new therapies and data
with your cancer doctor
• Be proactive and ask questions about how the new
information pertains to your situation
• Ask for clarity if you don’t understand
– Don’t be afraid to ask the ‘basic questions’
• Previsit – send your doctor questions electronically
– Allows for preparation
• Bring a list of written questions
• Extra set of ears is important!!
52. Communication Best Practices
• Every patient is unique. Your treatment plan will reflect a
personalized approach to your biology and situation.
• Keys to great doctor-patient relationship:
– Presence, Trust, Collaboration, Open minded
– Willingness to answer questions and address concerns
• There will be challenges
– Changes in therapy; Differences in Opinions
– Conversations about end of life care/planning
• Even in Zoom world; there is role for face to face discussions
– May be Different for Established vs. New Patients
53. How to find a clinical trial
• Ask you doctor
• Academic cancer center have intakes offices
– Nurse navigation and research staff
– Cancer center websites
• Clinicaltrials.gov
• Local and National Advocacy groups:
– ACS, CancerCare, Komen, Living Beyond Breast Cancer
– And many more