Neoadjuvant atezolizumab safe, meets primary endpoint of pathologic response rate
Neoadjuvant atezolizumab safe, meets primary endpoint of pathologic response rate
Lung CA seen on CXR. Credit: James Heilman, MD/Wikipedia
Primary analysis of the Lung Cancer Mutation Consortium (LCMC) 3 study revealed that neoadjuvant atezolizumab prior to lung cancer surgery was well tolerated by patients and met its primary endpoint of 20% major pathologic response rate, according to research presented today at the International Association for the Study of Lung Cancer’s…
Cancer scares people, and they get uncomfortable. Cancer is a word that strikes fear into people’s hearts, producing a deep sense of powerlessness. But the truth is, cancer has been both my enemy and my friend. I lost my mother to cancer whereas I survived an advanced stage 3B (triple-negative) breast cancer at the age of 32....
My Fight Against Breast Cancer
Cancer scares people, and they get uncomfortable. Cancer is a word that strikes fear into people’s hearts, producing a deep sense of powerlessness. But the truth is, cancer has been both my enemy and my friend. I lost my mother to cancer whereas I survived an advanced stage 3B (triple-negative) breast cancer at the age of 32. This is my story.
I was no stranger to cancer, it had touched my family earlier when my mother was diagnosed with breast cancer in 2003. She was treated and getting on with her life when cancer reared its head again in January 2006, this time more aggressive, attacking her liver, lungs, and brain. I saw her in pain and suffering.
Being her only child, she could never share her pain or problems with me. She wouldn’t accept the recurrence of the disease and slowly gave up the will to fight any further. She battled cancer for 4 years but eventually, we lost her to the disease at 55 years of age in 2007.
Cancer Came Knocking At My Door
It was April 2013 – I was just 32 then, I was accidentally hit on my left breast while walking on a busy Delhi street which I thought would heal on its own. However, the pain persisted even after a week and I realized it was time to consult a doctor.
I underwent a breast ultrasound, FNAC (a diagnostic procedure used to investigate lumps or masses under the skin) and biopsy, and the reports came positive for breast cancer at stage 3B (triple negative). Cancer was in an advanced stage and had occupied more than half of the left breast. Triple negative is a variant of breast cancer that has a tendency to spread faster to other organs. It also does not respond to hormonal tablets and was in most likelihood ‘inherited’.
My worst fear had now turned into a bitter reality. I thought my life was slipping out of my hands. “Why me?” this question kept bothering me for a long while. A strange anger was bubbling inside me. I was worried about my life but more so for my daughter. She was only twelve years old at that time.
I Took A Vow To Fight It Head On!
It was difficult but I had to accept it. Only by accepting, I was able to move on from there, making myself physically and mentally strong to fight the disease and face the side-effects of the treatment.
When you lean into the opening that a cancer diagnosis creates, you may quickly realize that all you have is the present moment. Being strong was my only choice. I imbibed this never-give-up fighter’s spirit from my mother. Giving up was never an option for me. I was determined to fight the disease. The support and understanding of my family and friends motivated me to give cancer a tough fight.
The Treatment Phase…
I underwent 6 cycles of neoadjuvant chemotherapy followed by 25 sessions of radiation. I also had to undergo mastectomy (surgical removal of a breast) of the affected breast. After my first chemotherapy, the pain was unbearable and it made me think of my mother and her suffering. I knew what I didn’t have to do. In a way, my mother’s situation taught me at least that.
I began to understand the changes my body was going through and prepared myself for each round of the treatment. Hair fall and mastectomy were really difficult to live with as it affected my self-confidence. I started welcoming advice and tips from friends and family and incorporated them the best I could. A positive attitude kept me going in those difficult days.
The Role of Chemotherapy in Triple Negative Breast Cancer by Almuradova DM in JUNS-Lupine Publishers
Breast cancer (BC) is the most frequent tumor worldwide. Triple-negative BCs are characterized by the negative estrogen and progesterone receptors and negative HER2, and represent 12-18% of all BCs. Breast cancer (breast cancer) is the most common oncological disease in women in the Uzbekistan. Data from epidemiological studies show that TNBC is more common in young women (up to 50 years) before menopause. In addition, the likelihood of TNBC is higher in women with early menarche, the first pregnancy at an earlier age, a short period of breastfeeding, and an increased body mass index.
Jeffrey Weber, MD, PhD: Dirk, what about neoadjuvant therapy? We actually, for the first time, heard about a neoadjuvant trial here at ESMO; this was Christian Blank’s study. So, is there a place for neoadjuvant therapy in patients with sort of the bulky high-risk stage IIIc disease, and now we call it stage IIId disease?
Dirk Schadendorf, MD:Yes. I think Caroline already…
The treatment of resectable stages of esophageal cancer often involves pre-operative concurrent chemoradiotherapy. This study aims to evaluate the effect of cisplatin/paclitaxel-based neoadjuvant chemoradiotherapy on pathologic stage and survival in patients with locally advanced esophageal cancer.
My second infusion, "neoadjuvant" chemotherapy, since it's administered before surgery - was on December 5th, 2014. My boyfriend worked from home that day so he could take me to treatment, but we fought that morning (why argue with someone about to get chemo?) so I went without him. I had enough on my mind, and pulsing through my body, that I just needed comfort and support. My mom insisted on coming with me, and I told her she was only welcome if she didn't talk about meatballs. My dear mom is off-the-boat Italian and all she talks about is food, especially meatballs; it satisfies her to feed me, and me being a picky eater...well, you can imagine our conversations! I was not excited about entering my second round of treatment. I was told to look at the treatment as soldiers running through my body, invading the cancerous cells. I preferred to think of them as hot, Roman gladiators like Russell Crowe! I was feeling a little back to normal, and I knew another wave of illness was going to overtake me; the nurse told me "the trick:" take the anti-nausea pill before I start feeling nauseous. Why didn't the oncologist tell me that? I learned the value of my chemo nurses, and I started to rely on them more and more. My nurse from today on is Sue, a familiar face: I worked with her twenty years ago when I was an admitting clerk in this Emergency Room. She was the head nurse back then, and very competent, so I know I'm in good hands. Back then she was very serious, but on the second floor, in the infusion room, she's gentle, kind and smiles a lot!
Neoadjuvant Chemotherapy in patients with breast cancer: Predictors of Locoregional Recurrence: NSABP B18+27
A smal number of patients with operable breast cancer receive neoadjuvant chemotherapy. So there is limited information on rates and predictors of locoregional recurrence (LRR) in these patients. Eleftherios and colleques analysed the results of following two trials including 3088 patients with breast cancer (T1-3 N0-1M0) receiving neoadjuvant chemotherapy between 1988 and 2000:
1. NSABP B-18: 742 patients undergoing 4 cycles of AC
2. NSABP B-27: 2346 (in 3 groups) patients were treated with 4 x AC neoadjuvant +/- 4x Docetaxel präoperative or postoperative
In both studies, patients undergoing lumpectomy received radiation therapy, patients treated with mastectomy received no radiation. The median follow up was 12 years:
Results:
Patients in the neoadjuvant CHX arms had LRR rates of 12,6% and 10,3 % (mastectomy vs. lumpectomy + RT) after 10 years. Significant independent factors of LRR were tumor size and clinical nodal status before therapy and pathological nodal status/breast tumor response and age (only in patients receiving RT).
The risk of LRR is althought increased with increasing number of positive nodes after neoadjuvant chemotherapy.
These informations can be used for predicting risk of LRR and for indicating the optimal use of RT after neoadjuvant chemotherapy.
