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  • #16
    Recently Published Study Shows Effective Treatment for Early-Stage Breast Cancer

    The TARGIT Collaborative Group (TCG) is pleased to announce publication of the long-term results of the Targeted Intraoperative Radiotherapy Trial (TARGIT-A Trial) comparing partial breast single fraction targeted intraoperative radiotherapy (TARGIT-IORT) to 3-6 week post-operative whole breast radiotherapy, demonstrating equivalent long-term outcomes between the two treatments. The results of the trial were published on August 19, 2020 in the British Medical Journal (

    The TARGIT-A Trial was a 2,298-patient multicenter, international, randomized controlled trial evaluating the use of TARGIT-IORT using the Intrabeam System (Carl Zeiss Meditec, Inc.) as a method of delivering IORT. TARGIT-IORT is typically administered in less than 30 minutes at the time of lumpectomy. TARGIT-IORT is the only method of delivering IORT widely available in the U.S. for which effectiveness has been proven in a randomized control trial.

    Dr. Valery Uhl, Radiation Oncologist and President of the TCG, stated: “We now have long-term proof that TARGIT-IORT is not only an effective—but in many ways superior—treatment for early-stage breast cancer. Every hospital where breast cancer surgery is performed should offer this form of radiation treatment to their breast cancer patients. Not only are long-term local control and cancer survival outcomes similar to whole breast radiotherapy, but mortality from other causes was lower in the IORT arm. TARGIT-IORT should be considered the new standard of treatment for early-stage breast cancer based on this large, multi-institutional, prospective, randomized controlled trial.”

    The TARGIT-A trial is largely responsible for the widespread adoption of IORT as a treatment option for early-stage breast cancer in the U.S. IORT is now covered by Medicare and most health plans. According to Breast Surgeon, Dr. Dennis Holmes, a TCG Founder and TARGIT-A Trial publication co-author, “in addition to being efficacious, separate publications have shown TARGIT-IORT to be associated with fewer side effects, improved quality of life, and reduced healthcare cost compared to whole breast radiotherapy.”

    Dr. Barry Rosen, Breast Surgeon and Secretary/Treasurer of TCG noted: “TARGIT-IORT is a safe, convenient, cost-effective alternative to WBRT that has virtually no side-effects and better cosmetic outcomes by virtue of its targeted therapy. I believe this establishes a new standard for patient-centered, precision oncology and should be offered to all breast cancer patients that meet eligibility requirements. Furthermore, the lower non-cancer mortality rates associated with IORT warrants further study.”:

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    • #17
      Study finds two drugs can reduce cancer spread after tumor removal

      A research group from Tel Aviv University (TAU) successfully reduced metastatic spread following tumor removal surgery in colorectal cancer patients.

      Using a short treatment around the time of the surgery, they were able to reduce stress responses and physiological inflammation, thus preventing the development of metastases in the years following the surgery.

      The study, recently published in the American Cancer Society journal Cancer, was led by Prof. Shamgar Ben-Eliyahu from the TAU School of Psychological Sciences and Sagol School of Neuroscience, and Dr. Oded Zmora from Shamir (Assaf Harofeh) Medical Center.

      The three-year study involved 34 patients. Over the course of 20 days — from five days prior to surgery until two weeks afterward — 16 of the patients received anti-anxiety and blood pressure-reducing drug Propranolol (Deralin) and anti-inflammatory analgesic Etodolac (Etopan), and 18 received a placebo treatment as a control group.

      Only two out of 16 patients receiving the drug treatment exhibited metastatic disease. In the control group, six out of 18 developed metastases, which is the usual rate for colorectal cancer patients.

      The treatment led to a reduction in the metastatic potential of the tumor and potentially the residual cancer cells.

      In addition, the drugs triggered good changes in patients’ white blood cell number and type, indicating a reduced chance of disease recurrence.

      “When the body is in a state of stress, whether physiological (from surgery) or psychological, this causes a release of high amounts of two types of hormones, prostaglandins and catecholamines,” Ben-Eliyahu explained.

      “These hormones suppress the activity of the immune cells, thus indirectly promoting the development of cancer metastases. In addition, these hormones also directly promote the acquisition of metastatic traits in cancer tissue.,” he continued.

      “Our study shows that inexpensive, accessible medication treatment could be used to reduce body stress responses and inflammation associated with surgery, which significantly reduces the risk of metastases that might be detected months or years after surgery.”

      Ben-Eliyahu now plans a large-scale clinical study to further test this treatment.: - https://acsjournals.onlinelibrary.wi...002/cncr.32950

      Keep your friends close and your enemies closer


      • #18
        Up to 1,000 downwinders likely got cancer from first atomic test, study says

        As many as 1,000 New Mexicans living in communities near Trinity Site, where the first atomic bomb was detonated 75 years ago, might have developed cancer from the radioactive fallout, says a long-awaited Cancer Institute report released Tuesday.

        The institute's findings were based on a six-year study that involved computer modeling, researching historical data and interviewing 210 elderly "downwinders" who lived close enough to the blast to suffer internal radiation exposure by ingesting contaminated milk and food.

        The number of cancer victims could be less than 1,000 but is unlikely to be more, the study says.

        There's also no clear evidence the radiation was severe enough to cause genetic abnormalities that could be passed by birth to subsequent generations, the study says.

        The study's authors concede there's much uncertainty in the report because so many years have passed since the test, the government didn't conduct public studies of the test's potential impacts on communities — due to the Manhattan Project's secrecy — and cancer cases weren't tracked nationally until the 1960s.

        The report comes after decades of criticism from downwinder advocates, who have accused the federal government of refusing to acknowledge affected residents to avoid liability.:
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        • #19
          Cancer cells take over blood vessels to spread

          In laboratory studies, Johns Hopkins Kimmel Cancer Center and Johns Hopkins University researchers observed a key step in how cancer cells may spread from a primary tumor to a distant site within the body, a process known as metastasis.

          Trying to determine how groups of cells migrate to other parts of the body, the scientists used tissue engineering to construct a functional 3D blood vessel and grew breast cancer cells nearby. They observed the cancer cells reaching out to the blood vessel and taking over a patch of the cell wall. As a result of this attachment to the blood vessel, a cluster of tumor cells were easily released into the bloodstream to travel to distant sites. Cancer cells also were able to constrict blood vessels, cause them to leak, or pull on them.

          A description of the work was published online July 14 in the journal Cancer Research.

          "We observed that cancer cells can rapidly reshape, destroy or integrate into existing blood vessels," says senior study author Andrew Ewald, Ph.D., co-director of the Cancer Invasion and Metastasis Program at the Johns Hopkins Kimmel Cancer Center and professor of cell biology at the Johns Hopkins University School of Medicine. The work was conducted in close collaboration with the lab of Peter Searson, Ph.D., the Joseph R. and Lynn C. Reynolds Professor of Materials Science and Engineering, with joint appointments in the departments of biomedical engineering, oncology and physical medicine and rehabilitation.

          "Just as people going scuba diving versus ice climbing require different tools, cancer cells bring different equipment depending on the job they intend to perform," Ewald says. "Determining what that equipment is can help us understand how to stop cancer." In this case, Ewald and collaborators expected to see groups of eight to 10 cells leaving a tumor, migrating through a protein barrier and squeezing between blood vessel walls to travel.

          "We never saw that," he says. "What we kept seeing instead was that a piece of an existing tumor would take over a neighboring blood vessel wall, putting cancer cells in direct contact with the circulation, and that the cancer cells could do so in a matter of hours. They didn't have to invade past the blood vessels; they became the blood vessels, and could just release cancer cells there."

          The "mosaic" vessels that result -- named because they consist of some natural blood vessel cells and some cancer cells -- were observed in about 6% of blood vessels in human breast tumors and in a mouse model of breast cancer in this and other studies, Ewald says. They also have been found in deadly brain tumors called glioblastomas, melanoma skin cancers and gastric cancers, he says. Their presence is associated with increased distant metastases.

          The 3D model could be adapted to study additional aspects of the tumor microenvironment or to study alternate cancer types, Ewald says.:

          Keep your friends close and your enemies closer


          • #20
            Pfizer's Ibrance kisses early breast cancer hopes goodbye with 2nd study failure

            After Pfizer’s Ibrance failed a crucial study in HR-positive, HR-negative postsurgery breast cancer patients, the company clung to hope that it could still show a benefit in a high-risk subset of those patients. But new data have officially snuffed out those hopes.

            The news didn’t surprise analysts, who widely expected a flop after Pfizer detailed its failed phase 3 Pallas trial at last month’s European Society for Medical Oncology virtual annual meeting. That study looked at Ibrance in the wider adjuvant group, showing the drug didn't deliver a benefit. In a subgroup breakdown Porges labeled “dismal,” Ibrance showed it didn’t help high-risk patients, either.

            But the Penelope-B stumble did bring a key question into sharper focus: Will its adjuvant showing hurt Ibrance in the metastatic setting, where it currently holds court?

            The way Porges sees it, it’s “inevitable that there is some spillover in terms of share of new starts in the metastatic setting,” given that Eli Lilly’s rival drug Verzenio is all lined up for an adjuvant green light after posting practice-changing data at ESMO. Adding the Lilly med to standard endocrine therapy after surgery slashed the risk of cancer recurrence by 25.3% among high-risk patients, results showed.

            The Penelope-B miss “further substantiates the hypothesis that Ibrance is an inferior molecule with less effective CDK inhibition than Lilly’s Verzenio,” Porges said.

            But RBC Capital Markets’ Randall Stanicky disagreed. “We don’t expect this to impact PFE's leading position in the metastatic setting, which as of today consists of ~79% of the CDK4/6 class,” he wrote of the Penelope-B data in his own Friday note to clients.

            Others, including Evercore ISI’s Umer Raffat, were less conclusive. Since the readout from Lilly’s successful adjuvant trial, monarchE, Ibrance hasn’t looked to be ceding its ground. “But we’ll track this dynamic over time,” he noted.

            Pfizer, for its part, has been vocal about the fact that it doesn’t expect to see its metastatic share slip.

            “I’ve got to say that all our interactions with thought leaders, through market research with medical oncologists that treat breast cancer, they look at early breast cancer very differently from metastatic,” Andy Schmeltz, global president and general manager of Pfizer's oncology unit, said in an interview ahead of ESMO, adding that “we do not expect any impact on Ibrance’s … positioning or performance in the metastatic setting.”

            But in the meantime, with an eye on clawing back a competitive edge, the company will be applying the learnings from its pair of trial misfires to up-and-coming CDK drugs in its pipeline.

            “We look forward to continuing to work with our research partners to understand subgroup data and how these could inform the development of our next-generation CDK inhibitors in early breast cancer,” Chris Boshoff, M.D., Ph.D., Pfizer’s chief development officer for oncology, said in a statement.:

            Keep your friends close and your enemies closer


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