FDA Expands Ribociclib Indication in HR-Positive, HER2-Negative Advanced, Metastatic Breast Cancer
On July 18, 2018, the U.S. Food and Drug Administration (FDA) expanded the indication for ribociclib (Kisqali) in combination with an aromatase inhibitor for pre/perimenopausal women with HR-positive, HER2-negative advanced or metastatic breast cancer, as initial endocrine-based therapy.
Drug Offers Extended Adjuvant Treatment Option for HER2+ Metastatic Breast Cancer
An estimated 266,120 new cases of invasive breast cancer and 40,920 related deaths will occur in the United States in 2018. Patients with distant disease have a poorer five-year relative survival rate (26.9%) compared with localized (98.9%) and regional (85.2%) disease. HER2+ breast cancer accounts for approximately 20%–25% of all breast cancer diagnoses, and this type of breast cancer is more common in younger women, decreasing in frequency with age across all stages.
The Case of the CTCAE Assessment for CDK4/6 Adverse Events
Mrs. Jones is a 66-year-old postmenopausal woman who developed left breast pain and a palpable mass. A mammogram and ultrasound showed a 4.6 cm mass with an enlarged axillary node. A core biopsy revealed invasive ductal carcinoma that is estrogen receptor positive, progesterone receptor positive, and HER2 negative. Positron-emission tomography and computed tomography scans revealed metastatic disease.
Childhood Cancer Act Signed Into Law; Study Finds That Many Patients With Breast Cancer Can Skip Chemo; Plan to Lower Drug Prices Could Increase Costs for Some Patients
It’s been a long time coming, but the Childhood Cancer Survivorship, Treatment, Access and Research (STAR) Act was finally signed into law on June 6 by President Trump. The act focuses on advancing pediatric cancer research and treatments along with improving screening programs and supporting patients into survivorship. As with many issues in the U.S. capital, the issue had two sides: many healthcare professionals see it as a win to support childhood cancer survivors, but it raised concerns for others about potential coverage issues.
Which Breast Cancers Benefit from Treatment With Cyclin-Dependent Kinase 4/6 Inhibitor Treatment?
Which Breast Cancers Benefit from Treatment With Cyclin-Dependent Kinase 4/6 Inhibitor Treatment?
A. Newly diagnosed DCIS
B. Metastatic, triple negative
C. Premenopausal, neoadjavant
D. ER+ metastatic
BRCA Mutations Point to Hereditary Breast and Ovarian Cancer Syndrome
Although all cancers have a genetic basis, a subset result from an inherited (i.e., germline) mutation that puts a person at increased risk for certain cancers. Unfortunately, the signs of hereditary cancer are often overlooked or misunderstood. Here’s what oncology nurses need to know about BRCA mutations, one of the more common mutations you’ll see in practice.
Labs Differ Widely in BRCA Testing Protocols
An international survey of 86 genetic testing labs showed inconsistent protocols and standards for analyzing the BRCA1 or 2 cancer susceptibility genes and their variations. The results were reported in NPJ Genomic Medicine.
Which Is a Breast Cancer Risk Factor?
Test your oncology knowledge with ONS. Which of the following is a risk factor for developing breast cancer?
- Women who are gravida 3 para 2
- Mild to moderate alcohol use
- Absence of the BRCA1 or BRCA2 mutation
- Going through menopause prior to age 55
Breast Cancer Chemo and Radiation Linked to Cellular Aging Markers
Women who receive chemotherapy or radiation therapy treatments for breast cancer are more likely to have high levels of DNA damage and reduced activity of an enzyme involved in chromosome healing than those who receive only surgery for breast cancer, according to the results of a study published in NPJ Breast Cancer.
Oncology Nurses Play Key Role in Genetics Education, Testing for Patients
Identifying genetically predisposed women with breast cancer who could benefit from risk assessment and genetic counseling is an important competency for oncology nurses. However, a recent study published in the Journal of Clinical Oncology (JCO) reported that fewer than 50% of newly diagnosed patients with breast cancer who should have been given formal genetic counseling actually received the appropriate genetic testing.
Massage Therapy Helps Manage Breast Cancer-Related Lymphedema
Lymphedema, the chronic swelling of a limb resulting from fluid accumulation, is a common sequela of surgery or radiation treatment for breast cancer. Nearly 90% of women who develop lymphedema do so within three years of treatment. Survivors commonly report physical and emotional distress, limitations to daily activities in fear of exacerbating lymphedema, and body image issues because of an abnormally enlarged limb.
FDA Approves Abemaciclib As Initial Therapy for HR-Positive, HER2-Negative Metastatic Breast Cancer
On February 26, 2018, the U.S. Food and Drug Administration (FDA) approved abemaciclib (Verzenio™) in combination with an aromatase inhibitor as initial endocrine-based therapy for postmenopausal women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 HER2-negative advanced or metastatic breast cancer.
FDA Approves Olaparib for Germline BRCA-Mutated Metastatic Breast Cancer
On January 12, 2018, the U.S. Food and Drug Administration (FDA) granted regular approval to olaparib tablets, a poly (ADP-ribose) polymerase (PARP) inhibitor, for the treatment of patients with deleterious or suspected deleterious germline BRCA-mutated (gBRCAm), HER2-negative metastatic breast cancer who have been treated with chemotherapy either in the neoadjuvant, adjuvant, or metastatic setting.
PCORI Helps Patients Choose the Right Breast Cancer Treatment
Many women face a lack of information and understanding after their breast cancer diagnoses. Currently, women have more treatment options than ever before, and patients have the ability to review the latest findings to identify the option that fits best for their lives.
Heart Failure Affects Long-Term Survival Among Older Women With Breast Cancer
Research has shown that women aged 65 and older who have breast cancer experience higher rates of heart failure compared to their age-matched counterparts, ranging from 29% of women with breast cancer who received no chemotherapy to 38% of women who received treatment with anthracyclines. However, little is known about the association between heart failure and long-term survival in older women with breast cancer, and it is unclear how the relative contribution of heart failure to mortality risk varies by breast cancer stage.
Sexual Function Varies by Some Treatments in Breast Cancer Survivors
Surgical modality and receipt of chemotherapy or radiotherapy are not associated with sexual function, as measured by the Female Sexual Function Index (FSFI). Patients receiving endocrine therapy with an aromatase inhibitor had significantly lower sexual function scores than those who received no endocrine therapy or those on tamoxifen, said a group of U.S. researchers who presented their findings during a poster session on Saturday, December 10, at the San Antonio Breast Cancer Symposium.
Latinas With BRCA1 or 2 Mutations Are More Likely to Choose Surgery
The uptake of prophylactic surgeries among Latinas with germline BRCA mutations may be slightly lower than what has been reported in non-Hispanic whites but higher than in African Americans, a group of U.S. researchers said. They presented their findings on Saturday, December 10, during a poster session at the San Antonio Breast Cancer Symposium.
Supervised Exercise Reduces Fatigue in Patients With Breast Cancer
Exercise—preferably supervised—represents a viable intervention for prevention and treatment of fatigue among patients with breast cancer, a group of Australian, European, and U.S. researchers said. They presented their findings during a poster session on Saturday, December 9, during the San Antonio Breast Cancer Symposium.
Type 2 Diabetes May Increase Breast Cancer Mortality in Hispanic Women
The presence of type 2 diabetes mellitus at the time of breast cancer diagnosis has been suggested to adversely affect survival—independent of breast cancer stage, grade, and tumor phenotype—but few of those studies included people of Hispanic descent. Researchers from Johns Hopkins Bloomberg School of Public Health in Baltimore and the University of Louisville in Kentucky examined the association between self-reported diabetes history, breast cancer-specific and all-cause mortality among Hispanic and non-Hispanic white women diagnosed with breast cancer. They presented their results on Saturday, December 9, during a poster session at the San Antonio Breast Cancer Symposium.
Community Breast Physicians Network Study Supports Broader Testing
Ongoing and increasing evidence suggest that an equivalent rate of mutations may be found regardless of whether patients meet current testing criteria, according to a large group of community breast physicians. They presented their findings on Friday, December 8, during a poster session at the San Antonio Breast Cancer Symposium.
Exercise Is Beneficial in Metabolic Syndrome
Metabolic syndrome is associated with increased risk of cardiovascular disease, type 2 diabetes, and possibly cancer recurrence, and its occurrence is higher in breast cancer survivors than age-matched postmenopausal women. Now, a study on exercise has found that aerobic and resistance exercise intervention reduced metabolic syndrome in sedentary, overweight, and obese Hispanic breast cancer survivors. U.S. researchers presented their findings during a poster session on Friday, December 8, at the San Antonio Breast Cancer Symposium.
Disparities Remain in Breast Cancer Mortality Based on Health Insurance Status
Significantly higher rates of death are found in Medicaid and uninsured hospital admissions when compared to Medicare-enrolled admissions with breast cancer, suggesting that insurance status “appears to play a crucial role in patient outcomes.” Researchers with Drexel University in Philadelphia presented their findings on Friday, December 8, during a poster session at the San Antonio Breast Cancer Symposium.
Younger Age Equates to Unfavorable Subtypes, Higher Stage, and Worse Survival in BC
Patients with breast cancer who are younger than 40 years are likely to have unfavorable subtypes, higher stage, and lower overall survival and disease-free survival (DFS) as compared to their older counterparts, according to researchers at the Roswell Park Cancer Institute in Buffalo, NY. They presented their findings on Friday, December 8, during the San Antonio Breast Cancer Symposium.
Serum Vitamin D Linked to Inability to Achieve Pathologic Complete Response
Vitamin D deficiency is associated with the inability to reach pathologic complete response (pCR) in patients with breast cancer undergoing neoadjuvant systemic chemotherapy (NAC), and a trend for worse survival was seen in patients with triple negative tumors. Results from an analysis were presented on Thursday, December 7, during a poster session at the San Antonio Breast Cancer Symposium (SABCS).
Factors Increase Risk for Fibrosis After Whole Breast Radiation Therapy in Lateral Position
Whole breast radiation therapy in isocentric lateral decubitus position is well tolerated with good cosmesis and low rates of fibrosis, said a group that had previously confirmed the efficacy and safety of the technique. Researchers from the Institut Curie in Paris presented their results during a poster session on Thursday, December 7, at the San Antonio Breast Cancer Symposium.
PRAEGNANT Breast Cancer Registry Suggests Chemotherapy Offers Little Benefit
A group of German researchers attempting to identify predictors for a decision against an antihormonal treatment (AHT) were unable to show that patients benefited from chemotherapy. They presented their results on Thursday, December 7, during a poster session at the San Antonio Breast Cancer Symposium.
Enrichment of Mucin Gene Family Shown in Breast Cancer Diagnosed During Pregnancy
The first study on the mutational landscape of breast cancer diagnosed during pregnancy (BCP) using whole-genome sequencing found that BCP is associated with a higher number of putative driver mutations, including mutations in mucin genes. Researchers presented their findings on Thursday, December 7, during a poster session at the San Antonio Breast Cancer Symposium.
Combination Checkpoint Inhibition/Epigenetic Modulation Improves Survival in HER2-Positive Breast Cancer Models
Researchers from Johns Hopkins University in Baltimore have found that adding the histone deacetylase inhibitor entinostat (ENT) to checkpoint inhibition decreases tumor burden and improves survival in human epidermal growth factor receptor 2 (HER2)-positive breast cancer models. The findings were reported during the San Antonio Breast Cancer Symposium on Wednesday, December 6.
Blocking ER-Coregulator Signaling Enhances Palbociclib Therapy in ER-Positive Breast Cancer
The novel combination of estrogen receptor (ER) coregulator binding modulator (ERX-11) and palbociclib may delay, or even overcome, endocrine therapy resistance in women with ER-positive advanced breast cancer, according to a group of researchers from the University of Texas (UT) Healthcare System. They reported their findings during the San Antonio Breast Cancer Symposium on Wednesday, December 6.
Extended Adjuvant Bisphosphonate Treatment Does Not Improve DFS, OS in Early-Stage Breast Cancer
Women with high-risk, early-stage breast cancer see no improvement in disease-free survival (DFS) or overall survival (OS) after five years of adjuvant bisphosphonate treatment compared with just two years of treatment, according to SUCCESS A, a phase III study. European researchers presented these findings during the San Antonio Breast Cancer Symposium on Wednesday, December 6.
African American Women Continue to Experience Breast Cancer Disparities
Despite interventions to bridge the gap in cancer disparities between African American and white women, racial disparities in breast cancer mortality exist. The National Cancer Institute reported that African American women have a higher mortality rate from breast cancer as compared to Caucasian women (33.8 versus 25.0, respectively).
Aggressive Treatment Needed for Locoregional Recurrence in Patients With Breast Cancer
Researchers from Memorial Sloan Kettering Cancer Center in New York, NY, suggested that for women with locoregional recurrence (LRR) of breast cancer, contralateral axillary metastases should be treated aggressively for cure after excluding distant metastases. Challenges of and best practices for managing LRR was discussed at an education session during the San Antonio Breast Cancer Symposium on Tuesday, December 5.
Bilingual, Bicultural Patient Navigators May Reduce Disparities in Latinas With Breast Cancer
Researchers from the University of Texas (UT) Health San Antonio have found that providing Latinas with breast cancer with a bilingual, bicultural patient navigator can improve access to care and reduce treatment delays. The researchers presented their findings during the San Antonio Breast Cancer Symposium on Tuesday, December 5.
FDA Approves Ogivri as a Biosimilar to Herceptin
On December 1, 2017, the U.S. Food and Drug Administration approved Ogivri (trastuzumab-dkst) as a biosimilar to Herceptin (trastuzumab) for the treatment of patients with HER2-overexpressing breast or metastatic stomach cancer (gastric or gastroesophageal junction adenocarcinoma).
Meditation Has Many Benefits for Patients With Cancer
Meditation is a healing practice that involves focusing attention, regulating breathing, and developing a nonjudgmental awareness of one’s thoughts and feelings. It aims to improve emotional regulation and overall well-being. Data from the 2012 National Health Interview Survey indicate that 18 million adults and 927,000 children practice meditation. Meditation encompasses repeating words with phonetic significance as in mantram meditation; paying attention or continually returning to the present moment as in mindfulness meditation; or practicing specific movements as in tai chi and qigong.
Why Breast Cancer Awareness Is Important All Year
As Breast Cancer Awareness Month begins this week, we’ll start seeing pink awareness efforts everywhere. Pink products will line the shelves at stores, awareness and fundraising ads will showcase celebrities wearing pink ribbons, and high school, collegiate, and even professional athletes will adorn their uniforms with pink, some even articulating a specific person or family member affected by breast cancer for whom they’re dedicating their athletic efforts.
FDA Approves Abemaciclib For HR-Positive, HER2-Negative Breast Cancer
On September 28, 2017, the U.S. Food and Drug Administration approved abemaciclib in combination with fulvestrant for women with HR-positive, HER2-negative advanced or metastatic breast cancer with disease progression following endocrine therapy.
Protein May Explain Chemo Resistance in Patients With BRCA2 Mutations
Researchers have discovered a protein that may lead to a new way to prevent resistance and improve outcomes for patients whose cancers have a BRCA2 mutation. The findings were reported in Molecular Cell.
ONS Lobbies for Breast Cancer Screening Act in Congress
Alongside congressional representatives Debbie Wasserman Schultz and Susan Brooks, ONS and other organizations are lobbying for support of the Protecting Access to Lifesaving Screenings (PALS) Act. This legislation would push insurance companies—along with the Veterans Health Administration—to provide access and coverage to breast cancer screenings for women aged 40–49.
The Role of Acupuncture in Treating Hot Flashes in Breast Cancer Survivors
Hot flashes, also known as hot flushes, are marked by periods of sudden, intense feelings of warmth that begin at the chest and radiate to the neck and face, along with flushing, sweating, and heart palpitations, lasting several seconds to minutes. Compared to healthy postmenopausal women, breast cancer patients and survivors are prone to experiencing more severe and longer-lasting hot flashes. A bothersome symptom, hot flashes can occur anytime during a 24-hour period, but those occurring at night are most troubling because they interfere with sleep. Sleep deprivation negatively impacts daytime functioning as well as pain, fatigue, depression, and anxiety levels, diminishing quality of life significantly.
FDA Broadens Palbociclib Indication in Breast Cancer
On March 31, 2017, the U.S. Food and Drug Administration (FDA) granted regular approval to palbociclib for the treatment of hormone receptor (HR)‑positive, human epidermal growth factor receptor 2 (HER2)‑negative advanced or metastatic breast cancer in combination with an aromatase inhibitor as initial endocrine based therapy in postmenopausal women.
Antidepressant May Relieve Joint Pain From Aromatase Inhibitors
The antidepression drug duloxetine, which is approved to treat depression, anxiety, fibromyalgia, and diabetes nerve pain, may also relieve treatment-induced joint pain in breast cancer survivors receiving aromatase inhibitor therapy, according to the results of a study presented at the San Antonio Breast Cancer Symposium.
FDA Approves Ribociclib for Breast Cancer Treatment
On March 13, 2017, the U.S. Food and Drug Administration (FDA) approved ribociclib (KISQALI®, Novartis Pharmaceuticals Corp.), a cyclin-dependent kinase 4/6 inhibitor, in combination with an aromatase inhibitor as initial endocrine-based therapy for the treatment of postmenopausal women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer.
Cancer Deaths Fall 25% Since 1991
Research, treatment, and technology surges throughout the 1990s have led to a 25% reduction in cancer mortality rates since 1991, according to the American Cancer Society’s (ACS’s) latest Cancer Statistics, 2017, report (Siegel, Miller, & Jemal, 2016). The decline in cancer-related deaths accounts for more than 2.1 million lives saved between 1991 and 2014.
The Case of the Breast Cancer Biology
Molly is a 48-year-old biology professor at a prestigious university. She was recently diagnosed with stage II invasive ductal carcinoma. She is referred to Anna, the breast nurse navigator, for breast cancer education and coordination of care.
Mammography Cutoffs Should Be Based on Individual Health History
Researchers conducting the largest study to date on screening mammography outcomes have found no evidence to support stopping mammography screenings at a certain age. The findings were presented at the 2016 Radiological Society of North America annual meeting.