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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: Mar 01 2012 at 1:53pm
updated entry under imaging in BC
http://forum.tnbcfoundation.org/topic9440_post97325.html#97325
on breast tomosynthesis (also known as 3D mammography)
which some centers are touting as the latest and greatest for BC screening.
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: Mar 01 2012 at 3:56pm
updated entry in chemo in TNBC
http://forum.tnbcfoundation.org/topic9440_post97306.html#97306
Identified a gene whose expression status is correlated with whether you get a pCR following neoadjuvant therapy with P-FEC in ER- patients; correlation with molecular subtypes.
Need more identification of genes like this to make personalized medicine more of a reality.
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: Mar 02 2012 at 11:18am
Updated entry under chemo in TNBC
http://forum.tnbcfoundation.org/topic9440_post97306.html#97306
importance of dosing scheduling for Avastin and other anti-angiogenic agents
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: Mar 05 2012 at 11:17am

Clotting problems in cancer and chemotherapy

 Bringing it up because I remembered someone on the forum mentioned that she was off chemo yet developed symptoms of pulmonary embolism.  Think everyone here should be aware of the potential risks, while on chemo and the fact that we have cancer.

WEBSITES

http://www.chemocare.com/managing/blood_clots_and_chemotherapy.asp

http://www.stoptheclot.org/faq/faq_blood_clots_cancer.htm

 

ARTICLES

Deep vein thrombosis in cancer: the scale of the problem and approaches to management

http://annonc.oxfordjournals.org/content/16/5/696.full

Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy

http://onlinelibrary.wiley.com/doi/10.1111/j.1538-7836.2007.02374.x/full

Acquired and inherited risk factors for developing venous thromboembolism in cancer patients receiving adjuvant chemotherapy: a prospective trial

http://annonc.oxfordjournals.org/content/21/4/871.full

The incidence of symptomatic thromboembolism in patients receiving adjuvant anthracycline-based chemotherapy for early stage breast cancer

http://www.thebreastonline.com/article/S0960-9776%2810%2900202-X/abstract

New insights into cancer associated thrombosis

http://atvb.ahajournals.org/content/29/3/316.short


From Donna

Semuloparin for thromboprophylaxis in patients receiving chemotherapy for cancer (SAVE-ONCO trial)

http://www.ncbi.nlm.nih.gov/pubmed/22335737

http://www.medpagetoday.com/MeetingCoverage/ASCOMeeting/26917

Higher Incidence of Venous Thromboembolism in the Outpatient Versus the Inpatient Setting Among U.S. Cancer Patients

http://ash.confex.com/ash/2011/webprogram/Paper37320.html






Edited by Lee21 - Mar 05 2012 at 3:26pm
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: Mar 05 2012 at 3:19pm
updated entry under Novel therapeutics -- articles found by Turtle
http://forum.tnbcfoundation.org/topic9440_post98426.html#98426

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: Mar 05 2012 at 4:23pm
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: Mar 07 2012 at 3:58pm

Taxanes

Several forum questions concerned Taxanes.  I did a literature search focusing on what  the recommendations are for type of taxane and dosing schedule.

My conclusions so far for high risk BC:

  • Weekly paclitaxel is superior (disease free survival) to q3 weekly paclitaxel x4 in the context of AC q3 weeks x 4 but with higher toxicity (peripheral neuropathy)
  • Weekly paclitaxel and docetaxel q3 weeks represent reasonable choices; docetaxel q3 weeks has higher toxicity (myelosuppression, febrile neutropenia, infection)
  • Docetaxel is too toxic in the dd setting
  • SWOG 0221 trial results pending comparing (1) DD ACx6 -> DD Taxol x6 (2) A (day1), oral C (days1-7) repeats q7 days x 15 course -> DD Taxol x 6 (3) DD ACx6 -> weekly Taxol x12
  • B-38 trial trial results pending, for node+ disease, compares ACT (every 3 weeks) x 6 to DD AC -> T to DD AC -> T+gemcitabine
  • Abraxane (nab-paclitaxel) is Cremophor-free, nanoparticle albumin bound paclitaxel.  Does NOT require steroid premed. Despite lower toxicity, better delivery, it is significantly more expensive.
  • Comparing weekly vs q3 weekly docetaxel in metastatic BC, at least 2 studies conclude that q3 weekly is better tolerated. In the neoadjuvant setting, one small study says weekly docetaxel is better tolerated than q3 weekly docetaxel but no differences in clinical response, pCR or overall survival (71.5 mo followup)
  • One study from Greece concluded paclitaxel did not have added benefit in TNBC (a different regimen than the typical ones used in the USA).
  • I haven't looked for long term taxane maintenace.
  • European studies have their own unique regimen and not entirely comparable to other trials.
  • I haven't come across the study that examined efficacy of dd paclitaxel vs standard vs weekly regimens, except for results pending from the SWOG trial.


Reviews

Docetaxel and Paclitaxel in the Treatment of Breast Cancer: A Review of Clinical Experience (2004 review)

http://theoncologist.alphamedpress.org/content/9/suppl_2/24.long

Conclusion: At the current time, the pharmacokinetic profile, consistent positive clinical results, and convenience of an intermittent, short-infusion schedule have made docetaxel the preferred taxane for many clinicians treating patients with breast cancer.

Choosing a taxane for adjuvant treatment of breast cancer: more than a flip of the coin? (2008)

http://www.ncbi.nlm.nih.gov/pubmed/18762793

No difference between docetaxel or paclitaxel but weekly is superior to q3 weeks.

Taxane vs. taxane: is the duel at an end? A commentary on a phase-III trial of doxorubicin and docetaxel versus doxorubicin and paclitaxel in metastatic breast cancer: results of the ERASME 3 study (2008)

http://www.ncbi.nlm.nih.gov/pubmed/17990102

Weekly paclitaxel and q3 week docetaxel are reasonable approaches

 

Trials

Phase III trial of nanoparticle albumin-bound paclitaxel compared with polyethylated castor oil-based paclitaxel in women with breast cancer (2005)

http://www.ncbi.nlm.nih.gov/pubmed/16172456

Conclusions: ABI-007 (Abraxane) demonstrated greater efficacy and a favorable safety profile compared with standard paclitaxel in this patient population. The improved therapeutic index and elimination of corticosteroid premedication required for solvent-based taxanes make the novel albumin-bound paclitaxel ABI-007 an important advance in the treatment of MBC

A phase II feasibility trial of dose-dense docetaxel followed by doxorubicin/cyclophosphamide as adjuvant or neoadjuvant treatment for women with node-positive or high-risk node-negative breast cancer (2008)

http://www.ncbi.nlm.nih.gov/pubmed/18650154

Conclusion: Full-dose docetaxel is difficult to administer as part of this dose-dense treatment regimen.  Docetaxel 75 mg/m2 can be administered with improved subsequent delivery of 4 courses of dose-dense AC. Until comparative clinical studies are available, docetaxel should not be substituted for paclitaxel in dose-dense adjuvant chemotherapy for patients with high-risk breast cancer.

Weekly paclitaxel in the adjuvant treatment of breast cancer (2008)

http://www.ncbi.nlm.nih.gov/pubmed/18420499

Conclusions: Weekly paclitaxel (compared to q3 weeks) after standard adjuvant chemotherapy with doxorubicin and cyclophosphamide improves disease-free and overall survival in women with breast cancer. (ClinicalTrials.gov number, NCT00004125 [ClinicalTrials.gov].

Intensive dose-dense compared with conventionally scheduled preoperative chemotherapy for high-risk primary breast cancer (2009)

http://jco.ascopubs.org/content/27/18/2938.long

Comparing (1) E q2 weeks x 3 -> Paclitaxel q2 weeks x 3 (2) E+Paclitaxel q3 weeks x 4.  After surgery, all patients received CMF.  CONCLUSION: Our results support the efficacy and short-term safety of IDD as preoperative chemotherapy. IDD was less well tolerated compared to standard treatment, but improved clinical outcomes in patients with noninflammatory high-risk primary BC.

Intense dose-dense sequential chemotherapy with epirubicin, paclitaxel, and cyclophosphamide compared with conventionally scheduled chemotherapy in high-risk primary breast cancer: mature results of an AGO phase III study (2010)

http://www.ncbi.nlm.nih.gov/pubmed/20458045

Their dose dense regimen: E (dd) q2 weeks x 3 -> Paclitaxel (dd) q2 weeks x 3 -> C (dd) q2 weeks x 3 compared to standard q3 week dosing x 4 cycles.  Has been criticized that the standard regimen was a suboptimal comparison.

Cyclophosphamide, epirubicin, and Fluorouracil versus dose-dense epirubicin and cyclophosphamide followed by Paclitaxel versus Doxorubicin and cyclophosphamide followed by Paclitaxel in node-positive or high-risk node-negative breast cancer (2010)

http://jco.ascopubs.org/content/28/1/77.long

Comparing (1) C (days 1-14), E (days 1, 8), F (days 1, 8) x6 (28 cycles)  (2) EC q2 weeks x 6 -> Paclitaxel q3 weeks x 4  (3) AC q3 weeks x 3 -> Paclitaxel q3 weeks x4

Conclusion: (3) is significantly inferior to (1) and (2)

Dose-dense doxorubicin and cyclophosphamide followed by dose-dense albumin-bound paclitaxel plus bevacizumab is safe as adjuvant therapy in patients with early stage breast cancer (2011)

http://www.ncbi.nlm.nih.gov/pubmed/21976055

Able to deliver a higher paclitaxel dose in the Abraxane formulation with no dose interruptions compared to cremophor-formulated paclitaxel

Effects on quality of life, anti-cancer responses, breast conserving surgery and survival with neoadjuvant docetaxel: a randomised study of sequential weekly versus three-weekly docetaxel following neoadjuvant doxorubicin and cyclophosphamide in women with primary breast cancer (2011)

http://www.ncbi.nlm.nih.gov/pubmed/21592370

CONCLUSIONS: Weekly docetaxel is well-tolerated and has less distressing side-effects, without compromising therapeutic responses, Breast Conserving Surgery (BCS) or survival outcomes in the neoadjuvant setting.

Triple-negative phenotype is of adverse prognostic value in patients treated with dose-dense sequential adjuvant chemotherapy: a translational research analysis in the context of a Hellenic Cooperative Oncology Group (HeCOG) randomized phase III trial (2012)

http://www.ncbi.nlm.nih.gov/pubmed/21901395

Smallish study from Greece where 298 tumors were profiled.  TNBC tumors were further characterized by CK5 or EGFR expression (core basal phenotype). Treatment regimen: E (dd) x 3 -> Paclitaxel (dd) x 3 -> CMF x 3 vs. E (dd) x 4 -> CMF x 4. Conclusion: No benefit from paclitaxel treatment was detected in any of the four subtypes or the total cohort. (luminal A, B, Her2 enriched and TNBC).

SWOG 0221 Trial comparing (1) DD ACx6 -> DD Taxol x6 (2) A (day1), oral C (days1-7) repeats q7 days x 15 coursed -> DD Taxol x 6 (3) DD ACx6 -> weekly Taxol x12

http://clinicaltrials.gov/ct2/show/NCT00070564?term=s0221&rank=1

 

Metastatic

Significantly longer progression-free survival with nab-paclitaxel compared with docetaxel as first-line therapy for metastatic breast cancer (2009)

http://www.ncbi.nlm.nih.gov/pubmed/19470941

Prospective multicenter randomized phase III study of weekly versus standard docetaxel (D2) for first-line treatment of metastatic breast cancer (2011)

http://www.ncbi.nlm.nih.gov/pubmed/21358208

Conclusions.  The present data support the feasibility of both weekly and 3-weekly application of docetaxel in combination with doxorubicin. Nevertheless, given that leukopenia was similar in both arms and the efficacy parameters were at least numerically inferior with the weekly schedule, standard 3-weekly application seems to be preferable for patients requiring combination chemotherapy.

Weekly docetaxel in metastatic breast cancer patients: no superior benefits compared to three-weekly docetaxel (2011)

http://www.ncbi.nlm.nih.gov/pubmed/21251813

CONCLUSION: Weekly docetaxel is less well tolerated than a 3-weekly schedule, due to more non-haematological toxicity, despite less febrile neutropenia. Also, no efficacy benefits can be demonstrated for weekly docetaxel, which may even be inferior based on multivariate analysis. Therefore, a 3-weekly schedule should be preferred in the setting of MBC.

3-16-12 entry

Acety L-carnitine in protecting against taxane-induced neuropathy

http://www.ncbi.nlm.nih.gov/pubmed?term=%22acetyl%20L-carnitine%22%20neuropathy




Edited by Lee21 - Mar 16 2012 at 9:18am
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: Mar 08 2012 at 11:00am
Tumor heterogeneity

Have you ever wondered what the significance is if your path report says only xx % of your cells are positive for a marker (be it hormone receptor, Her2, EGFR, cytokeratin, Ki67)?

A new study from the UK looked in depth at the genetic characteristics of different parts of a renal carcinoma from the same patient and from associated metastatic sites (4 patients total) and found a remarkable degree of intra-tumor heterogeneity. 

http://www.medpagetoday.com/HematologyOncology/OtherCancers/31545

http://www.scientificamerican.com/article.cfm?id=biopsies-found-provide-snapshot-tumor-diversity

Why is this finding important?

It means that the idea of characterizing a tumor by a few biomarkers and then basing therapy on those markers is probably too simplistic.

It could explain why cancer drugs stop working after a while if they target only a part of the tumor.

As suggested by the senior author, tumor heterogeneity could explain why some patients with renal cancer have better prognosis if their primary tumors are cut out, even if the tumor has spread.  This is because the primary tumor has the "evolutionary reservoir of diversity".

Breast cancer heterogeneity

Very likely the same thing is true for BC.

Heterogeneity in breast cancer
http://www.jci.org/articles/view/60534





Edited by Lee21 - Mar 08 2012 at 11:18am
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 11 2012 at 12:53am
Added:   To post of Feb 6, 2012      12;09 under CHEMOTHERAPY
on "open access" http://forum.tnbcfoundation.org/open-access-links-articles-tnbc_topic9440_page4.html

CTEP Meeting:     (CTEP=Cancer Therapy Evaluation Program of NCI)
“Preoperative Therapy in Invasive Breast Cancer: Reviewing the State of the Science and Exploring New Research Directions”    March 26-27, 2007
Included this link due to pdf and slides from this conference by experts.
Presentations also on surgery/radiation/imaging/research.
NOTE: Info from 2007.   One needs to read knowing that one will have to confirm if there is
             new info on the subjects addressed.
http://ctep.cancer.gov/highlights/20070326_meeting.htm

Info on CTEP: http://ctep.cancer.gov/default.htm
Maybe some one else can find more recent similar program of the CTEP on breast cancer.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Mar 14 2012 at 1:55pm
3-14-12 updated entries under chemo in TNBC
http://forum.tnbcfoundation.org/topic9440_post97306.html#97306

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: Mar 15 2012 at 10:44am
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: Mar 16 2012 at 9:20am
updated entry under taxanes
http://forum.tnbcfoundation.org/topic9440_post99093.html#99093
on acetyl L-carnitine in protecting against taxane induced neuropathy.
My NP said they did a small study at UM for this although the results aren't out and she recommended it.  I think others on the forum might also have been taking the supplement.
I could only find it in combo form with alpha lipoic acid.
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 rigatonismom Quote  Post ReplyReply Direct Link To This Post Posted: Mar 16 2012 at 9:52am
I asked my MO about acetyl L-canitine but because I'm in a clinical trial she said not until I finished with that.  She said if something went south, they wouldn't know if it was the PARP or the acetyl L-carnitine.  She said I probably could when I'm finished with the trial.  Two women in my support group have and are using it and they swear it is helping with the neuropathy.
Nita
DX 09/10 TNBC Stage3c, grade3, Tumor 2.7cm, chemo started 9/29/10, AC x4, Taxol x12, lumpectomy 4/11/11-tumor .6cm, 3+/22 nodes, radiation x 30 finished 6/30/11.Clinical Trial Cisplatin,PARP 8/23/11
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Mar 18 2012 at 11:38am
BRCA1/BRCA2 and homologous recombination pathway related information

Came across this paper and reminded me of George Sledge's description of smart cancers:

Resistance to therapy caused by intragenic deletion in BRCA2
http://www.nature.com/nature/journal/v451/n7182/full/nature06548.html
Researchers isolated PARP inhibitor-resistant clones from a human pancreatic cancer cell line that is BRCA2 deficient (c.617delT) and found that new BRCA2 isoforms were expressed that have deleted the mutation and restored the messenger RNA reading frame. They also found similar restoring mutations in carboplatin-resistant ovarian tumors from c.617delT mutation carriers.
(PARP inhibitors depend on the homologous recombination pathway involving BRCA1/2 to be deficient and on the cell to rely on the DNA base excision repair pathway to take over, the latter being targeted by PARP inhibitors).

Good update on PARP inhibitor trials and the road forward (unfortunately not OPEN ACCESS)
Stumbling Blocks on the Path to Personalized Medicine in Breast Cancer: The Case of PARP Inhibitors for BRCA1/2-Associated Cancers
http://cancerdiscovery.aacrjournals.org/content/1/1/29.abstract



Edited by Lee21 - Mar 18 2012 at 1:57pm
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: Mar 18 2012 at 4:04pm
Updated entry in chemo in TNBC (on consensus recommendations for neoadjv. chemo)
http://forum.tnbcfoundation.org/topic9440_post97306.html#97306

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: Mar 19 2012 at 5:18pm
updated entry under novel therapeutics and targets
http://forum.tnbcfoundation.org/topic9440_post98426.html#98426
new target from ISPY trial
This is the way to go: molecular information from trial --> hypothesis generation --> test in lab --> (hopefully) new target and drug to test in next trial.
CDK inhibitors not part of first round of drugs tested in ISPY2 trial -- the trial design is adaptive, meaning that they have a pipeline of new investigational drugs to roll through, without having to file a new trial and get FDA approval.
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 ds21 Quote  Post ReplyReply Direct Link To This Post Posted: Mar 26 2012 at 12:22am
Possible genetic marker for risk of taxane neuropathy

This is a preliminary finding and subject to significant questions, but potentially an interesting lead on finding genetic markers to help predict who is at risk for taxane induced neuropathy

Breast Cancer Res Treat. 2011 Dec;130(3):993-1002. Epub 2011 Jul 16.

Genetic predictors of taxane-induced neurotoxicity in a SWOG phase III intergroup adjuvant breast cancer treatment trial (S0221).


http://www.ncbi.nlm.nih.gov/pubmed/21766209

One big caveat is they only looked at two genes, BRCA1 and FANCD2.  They found an association between some variants of FANCD2 and increased risk for taxane neuropathy, but this is not a genome wide search.   A second big caveat is that taxane induced neuropathy is more common is women of African descent and the variants in FANCD2 that were associated with increased risk are also more frequently found in women of African descent so at this point it is hard to rule out "true, true and unrelated" as an explanation.  Nevertheless, the fact that different populations have different risk for neuropathy does suggest that there is a genetic component and potentially a way to identify people with a higher risk.

David


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Mar 26 2012 at 4:58pm
updated entry in chemo in TNBC
http://forum.tnbcfoundation.org/topic9440_post97306.html#97306
-- consensus recommendations of different treatments for different subtypes
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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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: Mar 26 2012 at 8:19pm
updated entry on supplements, activity...
http://forum.tnbcfoundation.org/topic9440_post96184.html#96184
(a really good website)
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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Lee21 View Drop Down
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Joined: Dec 22 2011
Location: Michigan
Status: Offline
Points: 736
Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Mar 31 2012 at 10:44am
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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