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Lee21 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 19 2012 at 2:06pm
updated entry under 1) chemo in TNBC (a phase 2 trial involving Avastin, led by Sledge) and 2) metastatic TNBC (brain mets) -- should read this 2 page article to get a better understanding about the difficulty treating brain mets
12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 19 2012 at 9:03pm

Treatment of chemotherapy associated anemia and other side effects

Note: Aranesp (Darbepoietin Alpha) is a recombinant form of erythropoietin engineered to contain extra N-linked carbohydrate chains (sugar chains)

Reviews:

Anemia in Cancer (open access)

http://annonc.oxfordjournals.org/content/21/suppl_7/vii167.full.pdf+html

Erythropoietin in cancer patients: pros and cons

http://www.ncbi.nlm.nih.gov/pubmed/20498598

 

Practice guidelines

http://bloodjournal.hematologylibrary.org/content/116/20/4045.full.pdf+html

 

Clinical studies

Incidence and risk factors of anemia in patients with early breast cancer treated by adjuvant chemotherapy

http://www.ncbi.nlm.nih.gov/pubmed/22123411

You are at risk if you have these risk factors: 1) exposure to taxane 2) high dose anthracyclin  3) Hemoglobin at base line of < 13.5 g/d  4) age >60  5) thin (BMI <25) 6) mastectomy (curious about the last one)

Complications associated with erythropoietin-stimulating agents in patients with metastatic breast cancer: a Surveillance, Epidemiology, and End Results-Medicare study

http://onlinelibrary.wiley.com/doi/10.1002/cncr.25972/abstract

Increases the risk of thrombosis and strokes

 

Pre-clinical concerns (related to the fact that many BCs express the receptor for erythropoietin)

Recombinant human erythropoietin in combination with chemotherapy increases breast cancer metastasis in preclinical mouse models (OPEN ACCESS)

http://clincancerres.aacrjournals.org/content/17/19/6151.long

Unfavorable drug interactions in targeted breast cancer therapy

http://www.cell.com/cancer-cell/retrieve/pii/S1535610810004290

2-21-12 note:  apparently there is disagreement regarding the expression of the Epo receptor on tumor cells due to use of an antibody that is not specific for EpoR.

2-28-12 entry

Management of febrile neutropenia and cardiac toxicity in the adjuvant treatment of breast cancer (2007)

http://cigjournals.metapress.com/content/v13635236120hr14/

(open access) good article



Edited by Lee21 - Feb 28 2012 at 2:22pm
12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 22 2012 at 3:58pm
new entry under chemo in TNBC
surprised to find out the CALGB 40603 trial for TNBC has been suspended. Anyone know why?
http://clinicaltrials.gov/ct2/show/study/NCT00861705?term=CALGB+40603&rank=1&show_locs=Y#locn

12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 22 2012 at 5:27pm
Breast Cancer–Associated Abraxas Mutation Disrupts Nuclear Localization and DNA Damage Response Functions

http://stm.sciencemag.org/content/4/122/122ra23.abstract

http://health.usnews.com/health-news/news/articles/2012/02/22/researchers-spot-new-gene-mutation-linked-to-breast-cancer

Abraxas is part of the BRCA1 protein complex.
Only 4 cases (Finland) but the tumors are ER+ PR+ HER2-.  Mentioned that even with BRCA2 mutated tumors frequently show hormone receptor positivity.  So need more cases to see if TNBC is part of the spectrum.

2-25-12
note: this will be folded into a previous post on the identification of genetic risk loci for BC (now titled : Breast cancer associated genetic risks


Edited by Lee21 - Feb 25 2012 at 10:03am
12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 23 2012 at 9:44am
Metastasis

Researchers Reveal How Cancer Cells Change Once They Spread to Distant Organs
Cornell Center on the Microenvironment and Metastasis and Neuberger Berman Lung Cancer Research Center Findings Suggest Targeting a Single Protein May Help Stop Cancer Spread


http://weill.cornell.edu/news/releases/wcmc/wcmc_2012/02_22-12.shtml

Myeloid progenitor cells in the premetastatic lung promote metastases by inducing mesenchymal to epithelial transition

http://cancerres.aacrjournals.org/content/early/2012/01/24/0008-5472.CAN-11-2905.abstract

2-24-12 note:  this post has been folded into the metastatic TNBC post



Edited by Lee21 - Feb 24 2012 at 11:03am
12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 23 2012 at 8:53pm
update entry under nutrition on Curcumin.  Very good article, especially about whether to take curcumin supplements while on chemo.
12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 24 2012 at 11:18am
Novel therapeutics and targets for Breast Cancer

Cabozantinib, an inhibitor of two tyrosine kinase receptors: c-MET and VEGFR2

http://www.newscientist.com/article/dn21516-new-cancer-drug-sabotages-tumours-escape-route.html

So far, trials in prostate cancer only but studies in mouse model for breast cancer suggests efficacy:
Cabozantinib (XL184), a novel MET and VEGFR2 inhibitor, simultaneously suppresses metastasis, angiogenesis, and tumor growth
http://www.ncbi.nlm.nih.gov/pubmed/21926191

Cabozantinib has been shown to be effective in pre-clinical studies of several different cancers.

Another monoclonal antibody targeting c-MET onartuzumab is in clinical trials for metastatic TNBC:
http://clinicaltrials.gov/ct2/show/NCT01186991?term=onartuzumab&rank=4

From Turtle:

This paper describes the use of mTor inhibitors in breast and ovarian cancer models, and is relevant because of ongoing (or canceled?) clinical trials using an mTor inhibitor in breast cancer (not sure if TN was broken out). The paper essentially concludes that they get the best effect when they use a combination of an mTor inhibitor and a Bcl2 inhibitor.
http://www.ncbi.nlm.nih.gov/pubmed/22340595 

I brought up this paper on a previous thread about lymphovascular invasion, since it essentially claims that using pericyte coverage is an important prognostic indicator of systemic recurrence. It is also important because it suggests that use of single agent tyrosine kinase inhibitors can paradoxically shrink the primary tumor, while promoting metastasis by upregulating hypoxia in the primary tumor, thereby driving EMT by upregulating cMet expression. Again, I think there have been several clinical trials (that may be suspended) using various tyrosine kinase inhibitors for breast cancer (but maybe only in the metastatic setting?).

A related paper suggesting similarly that antiangiogenic therapies such as sunitinib (tyrosine kinase inhibitor) or bevacizumab (VEGF antibody) increase hypoxia thereby upregulating cancer stem cells comes to similar conclusions, in that drugs targeting specific kinases be used in combination therapy, rather than monotherapy.

Subtype and pathway specific responses to anticancer compounds in breast cancer (OPEN ACCESS)
http://www.pnas.org/content/109/8/2724.long

3-19-12 entry
Myc pathway activation in triple-negative breast cancer is synthetic lethal with CDK inhibition
http://jem.rupress.org/content/early/2012/03/13/jem.20111512
-- results from the original ISPY trial.
33 out of 36 TNBC tumors had a high-intermediate Myc gene signature score, correlating with worse outcome : diminished disease-free survival in patients whose tumors exhibited poor response to neoadjuvant treatment.
Increased Myc expression makes tumor cells more sensitive to CDK inhibition.  CDK = cyclin dependent kinase consists of a group of kinases that function in the cell cycle.  They tested 2 CDK inhibitors, one dinaciclib is in phase 2 trial for different cancers.

3-29-12 entry

Drug candidates derailed in case of mistaken identity

PARP inhibitor that wasn't highlights widespread flaws in preclinical studies.

http://www.nature.com/news/drug-candidates-derailed-in-case-of-mistaken-identity-1.10341


Edited by Lee21 - Mar 29 2012 at 11:41am
12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Grateful for today Quote  Post ReplyReply Direct Link To This Post Posted: Feb 24 2012 at 6:11pm
Added to post of Feb6, 2012    12:09
AWS: Axillary web syndrome (cording).   Infrequent postop complication.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724805/
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 25 2012 at 10:01am
updated entries under 1) chemo in TNBC; 2) metastatic TNBC
12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 26 2012 at 11:50am
Chemo brain


Popular articles

Your Brain After Chemo

http://awomanshealth.com/your-brain-after-chemo/

Breast Cancer: ‘Chemo Brain’ Associated with Circulating Tumor Necrosis Factor

http://journals.lww.com/oncology-times/blog/asco11spotlightnews/pages/post.aspx?PostID=30

Doxorubicin

http://www.med.nyu.edu/content?ChunkIID=165778

 

Medical articles

Mechanisms (possible) for chemo brain

Expression of Inflammatory Molecules Among Breast Cancer Patients Receiving Different Chemotherapies:Implications for Chemobrain (abstract only)

http://cebp.aacrjournals.org/content/19/3/896.2.short

A proposed mechanism for chemotherapy-related cognitive impairment ('chemo-fog') (2011)

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2710.2010.01188.x/abstract

(suggests that excessive cytokine release by cytotoxic drugs may cause chemo brain)

 

Pre-clinical

Systemic 5-fluorouracil treatment causes a syndrome of delayed myelin destruction in the central nervous system

http://jbiol.com/content/7/4/12

Adriamycin-mediated nitration of manganese superoxide dismutase in the central nervous system: insight into the mechanism of chemobrain

http://onlinelibrary.wiley.com/doi/10.1111/j.1471-4159.2006.04179.x/full

Alterations in brain antioxidant enzymes and redox proteomic identification of oxidized brain proteins induced by the anti-cancer drug adriamycin: implications for oxidative stress-mediated chemobrain

http://www.sciencedirect.com/science/article/pii/S0306452210000692

 

Clinical

New advances in molecular mechanisms and the prevention of adriamycin toxicity by antioxidant nutrients

http://www.sciencedirect.com/science/article/pii/S0278691510002218

The cognitive effects of chemotherapy in post-menopausal breast cancer patients: a controlled longitudinal study

http://www.springerlink.com/content/c607862163782141/

The fog hasn't lifted on "chemobrain" yet: ongoing uncertainty regarding the effects of chemotherapy and breast cancer on cognition (2010) Editorial to above article (Tager et al.)

http://www.springerlink.com/content/r531702311168077/

Preliminary results of a longitudinal study of changes in cognitive function in breast cancer patients undergoing chemotherapy with doxorubicin and cyclophosphamide

http://onlinelibrary.wiley.com/doi/10.1002/pon.1342/abstract

Two different sides of 'chemobrain': determinants and nondeterminants of self-perceived cognitive dysfunction in a prospective, randomized, multicenter study (2010)

http://onlinelibrary.wiley.com/doi/10.1002/pon.1695/full

Cognitive functioning after cancer treatment: A 3-year longitudinal comparison of breast cancer survivors treated with chemotherapy or radiation and noncancer controls (2011)

http://www.ncbi.nlm.nih.gov/pubmed/22161750

Neuropsychological Performance in Survivors of Breast Cancer More Than 20 Years After Adjuvant Chemotherapy
http://jco.ascopubs.org/content/early/2012/02/27/JCO.2011.37.0189.abstract

looking at CMF

Long term effects on brain white and grey matter

Is a picture worth a thousand (forgotten) words?: neuroimaging evidence for the cognitive deficits in 'chemo-fog'/'chemo-brain' (2010)

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2710.2009.01044.x/full

**Longitudinal Assessment of Chemotherapy-Induced Structural Changes in Cerebral White Matter and Its Correlation With Impaired Cognitive Functioning (2011)

http://www.ncbi.nlm.nih.gov/pubmed/22184379

(both structural changes in brain white matter and changes in neuropsychologic testing)

CONCLUSION We report evidence of longitudinal changes in cognitive functioning and cerebral WM integrity after chemotherapy as well as an association between both.

"Doctor, will the treatment you are recommending cause chemobrain?" (2011)

http://jco.ascopubs.org/content/30/3/229.short

(editorial to article “Longitudinal Assessment….”)

Global and focal brain volume in long-term breast cancer survivors exposed to adjuvant chemotherapy (2011)

http://www.springerlink.com/content/v00451777l542722/

“This study shows that adjuvant chemotherapy for breast cancer is associated with long-term reductions in TBV and overall gray matter volume in the absence of focal reductions. The observed smaller gray matter volume in chemotherapy-exposed survivors was comparable to the effect of almost 4 years of age on gray matter volume reduction. These volume differences might be associated with the slightly worse cognitive performance that we observed previously in this group of breast cancer survivors.”



Edited by Lee21 - Feb 28 2012 at 10:47am
12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Grateful for today Quote  Post ReplyReply Direct Link To This Post Posted: Feb 26 2012 at 12:20pm
Some other chemo brain articles, links added to post of Feb 6, 2012    12:09

Note: If anyone knows if it is possible to add to another's post, please post how
            to do that.
           For example, would prefer to add Lee's post above rather than added to
           the Feb 6, 2012 post ( Since I posted the Feb 6 post, I could add to the
           FEB 6 post by editing it. Can not/do not know how to add/edit to above
           Lee's post on chemo brain).............Thanks.

Grateful for today.........Judy

Edited by Grateful for today - Feb 26 2012 at 12:23pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote ds21 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 26 2012 at 12:51pm
In the forum a post "belongs" to the original author so by design, only the original author can edit it. There are wiki systems designed for community editing. Most well known example is Wikipedia, but there are thousands of wikis on the web and free packages for setting them up. I asked Arlene about the possibility of setting up a wiki on the tnbcf site. Seems like there is a need.

David
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 28 2012 at 11:54am
Updated entry under metastatic TNBC
Incidence of brain metastases as a first site of recurrence among women with triple receptor-negative breast cancer

http://forum.tnbcfoundation.org/open-access-links-articles-tnbc_topic9440_page5.html


Edited by Lee21 - Feb 28 2012 at 11:55am
12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 28 2012 at 2:23pm
Updated entry under chemotherapy induced anemia and side effects -- page 6
12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 28 2012 at 3:45pm
12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Charlene Quote  Post ReplyReply Direct Link To This Post Posted: Feb 28 2012 at 4:31pm
Lee,
Again thanks for all the new information.  I just tried to access the above entry, however, and it wouldn't come up.
Charlene
DX 3/10 @59 ILC/TNBC
Stage 1, Grade 2, Multifocal; Lumpectomy/re-excision
SNB 0/4 nodes, BRCA-; Taxotere/Cytoxan X4, 30 rads
3/14:NED
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 28 2012 at 4:58pm
Fixed, it takes a few seconds to connect. Thanks for bringing it up.
12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 29 2012 at 7:23am
12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 29 2012 at 2:29pm
Updated entry under Micromets on the role of ALND in clinically node negative or minimally positive SN patients
http://forum.tnbcfoundation.org/topic9440_post97473.html#97473

12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Grateful for today Quote  Post ReplyReply Direct Link To This Post Posted: Mar 01 2012 at 1:43am
added to post of Feb 6, 2012     12:09
   http://forum.tnbcfoundation.org/open-access-links-articles-tnbc_topic9440_page4.html

RESIDUAL CANCER BURDEN
*Residiual cancer burden: The MD Anderson calculator for RCB (residual cancer burden)*.
THE RCB calculator is used to determine risk of recurrence after breast cancer surgery that was
preceeded by neoadjuvant chemotherapy.
Find at: http://www3.mdanderson.org/app/medcalc/index.cfm?pagename=jsconvert3

*Residual cancer burden: Article on RCB by W.F. Symmans and all:
    http://jco.ascopubs.org/content/25/28/4414.full

*Residual cancer burden: slides from W.F. Symmans 2007 CTEP presentation *
CTEP: Cancer Therapy Evaluation Program)
http://ctep.cancer.gov/highlights/docs/symmans.pdf

BREAST CANCER
*Breast Cancer heterogeneity. One term-many entities*                 
http://m.jci.org/articles/view/57100


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