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Triple negative breast cancer and chemo

mimivac's picture
mimivac
Posts: 2147
Joined: Dec 2008

This came out in the New England Journal of Medicine on May 14th. Apparently, older women with early stage receptor status negative breast cancer (as well as those with positive receptors) did much better on standard chemotherapy than on Xeloda, which is becoming a treatment option for certain triple negatives. Even though I am not over 65, it is good hear that study subjets who received standard chemo had an overall survival rate of 91%. Here is a synopsis:

"Standard chemotherapy more effective than capecitabine for older women
Older women with early-stage triple negative breast cancer had four times the chance of relapse if they were treated with the chemotherapy drug capecitabine (Xeloda ) rather than standard chemotherapy, either cyclophosphamide/methotrexate/fluorouracil, or doxorubicin/cyclophosphamide. Their risk of death was three times higher.

Capecitabine is taken orally.

Women 65 and older were randomly assigned to standard chemotherapy or capecitabine . Among the patients in the standard chemotherapy group, 133 chose cyclophosphamide/methotrexate/fluorouracil, 184 chose doxorubicin/cyclophosphamide and nine withdrew without choosing a treatment.
CMF was administered in standard doses for six cycles repeated every six weeks.

AC was administered in standard doses for four cycles repeated every three weeks.

Capecitabine was administered in two divided doses for 14 consecutive days every three weeks for six cycles.

Patients were evaluated at an average of 2.5 years. For all women regardless of receptor status, those in the capecitabine group had double the risk for recurrence and a similar risk for death. Breast cancer was the most common cause of death in the capecitabine group compared with other cancers or cardiovascular disease for patients in the standard chemotherapy group.

But when women were further evaluated by receptor status, those in the triple negative group fared even worse, with four times the risk of recurrence and three times the risk of death.

Standard chemotherapy also resulted in increased estimated three-year relapse-free survival (85percent vs. 68percent) and overall survival (91percent vs. 86percent) compared with capecitabine for all women, regardless of hormone status.

The data were published in the May 14 issue of The New England Journal of Medicine."

Aortus's picture
Aortus
Posts: 967
Joined: Jan 2009

Thanks so much for sharing the great info, Mimi! How on earth do you find all this new stuff? We're meeting with our St. Louis oncologist this afternoon, and will certainly pass along anything new we come across.

Joe

mimivac's picture
mimivac
Posts: 2147
Joined: Dec 2008

Joe, if it's not too late, I found something else interesting you might want to ask about. It's from a study that came out of the Impakt Breast Cancer Conference in Brussels and talks about androgen receptors. This is a new concept for me. A summary:

"Androgen receptors: a new category of triple negative breast cancer?
Another receptor—the androgen receptor—is being studied to help evaluate the aggressiveness of breast cancer tumors and how they react to treatment

“I think we are seeing the birth of a new concept in breast cancer—the androgen-receptor-positive breast cancer,” says Jose Baselga, M.D., co-chair of the Impakt Breast Cancer Conference in Brussels, Belgium. “This is an important development in finding new targets that we can attack with new drugs in the future.”

The Impakt conference was sponsored by the European Society for Medical Oncology May 7-8, 2009.

Patients who were triple negative breast and who also had androgen receptors tended to react less favorably to chemotherapy than those without the receptors.

A clinical trials is now underway to target these receptors, with the hopes of using it for prognosis and the development of drug therapy."

Christmas Girl's picture
Christmas Girl
Posts: 3644
Joined: Apr 2009

Are your keen research abilities - and the amazing way you translate complicated & technical into "layman's terms" - in any way connected to your government job? Just kidding!!! :-)

Am enjoying your new pic - from your post-chemo & pre-rads vacation? You look lovely, as does the backdrop.

Kind regards, Susan

mimivac's picture
mimivac
Posts: 2147
Joined: Dec 2008

Yes, the picture was taken in Puerto Rico on our hotel room patio. The blue you see behind me is the Caribbean.

Christmas Girl's picture
Christmas Girl
Posts: 3644
Joined: Apr 2009

Been thinking about you, Moopy. You, too, Joe. Warmest best wishes for the best possible outcome from this very important appointment later today. I'm sending lots of HOPE!

Kind regards, Susan

mimivac's picture
mimivac
Posts: 2147
Joined: Dec 2008

Joe and Moops, please let us know the outcome when you can. I am thinking of you.

Mimi

cats_toy's picture
cats_toy
Posts: 1463
Joined: Feb 2009

I am seconding Susans wishes, let us know how it goes!

=^..^=

Aortus's picture
Aortus
Posts: 967
Joined: Jan 2009

Moopy's appointment this afternoon went very well. Not that there weren't surprises, but our oncologist was most gracious with her time and attention. She is an amazing physician and an amazing woman.

Some tips before I forget: 1) if you had Adriamycin and/or radiation on the left (heart) side, our oncologist recommends monitoring by a cardiologist with chemo experience. 2) close monitoring by one's PCP or internist is important. 3) During radiation and up to 3 months afterward, one is at increased risk of dry cough and shortness of breath - so report it right away. 4) Keep the port in until this period is over; it will be useful for treating the cough/breath condition if needed. 5) Skin which has turned brownish will get back to its normal color if one uses sunblock.

As for treatment post-rads, our oncologist strongly believes in not using additional treatments until they are proven necessary. She was also not keen - and that is a considerable understatement - about Moopy participating in clinical trials, Stage II and below.

Thank you all for your concern. We are both feeling uplifted and your good wishes and kind thoughts mean so much to us!

Joe (and the Moopster too)

Christmas Girl's picture
Christmas Girl
Posts: 3644
Joined: Apr 2009

It all sounds really good, just great! Most importantly, your confidence in Moopy's "2nd opinion" oncologist is comforting to all of us who care so much about Moopy, and you.

So glad you're BOTH feeling UPLIFTED! YAY! :-)

Thanks for the update. Now, on to rads!

Kind regards, Susan

djteach's picture
djteach
Posts: 275
Joined: Apr 2009

Thanks MiMi,
Thank you for all of the research you do and share with us. I have learned so much from the sisters and brothers here you just wouldn't believe.

I wanted to but into this thread because of the information that Moopy and Aortus shared from their onc. I had the andriamycin or Red Devil is what my onc called it. Before chemo, I had no heart problems, not even high cholestoral. I had 5 different drugs in my "cocktail". My first chemo was on sept.5 of '05 and I had two heart attacks by oct. 8. I didn't know what the first one was. My second one lasted about 20 min. and I still wasn't sure what it was. I called my onc. the next morning and was sent to the emergency room immediately. I was so lucky. Both my cardiologist and my onc. agreed that it was the combo of the cocktail, but especially the red devil that was the culprit combined with the radiation that I had between my 1st and 2nd chemo. So it really does happen. Luckily, I have regained 95% of my heart muscle function back, Yeah! I hope it never happens to anyone else.

I'm glad that everything is going so well for you, Moopy. You, MiMi and 12/25 are my heros. Aortus, you are a hero too for being so involved with your wife's survival and you remind me of my baby brother.(that's a compliment)

MiMi, keep that info coming because it makes sense when you say it. I used to be able to read and understand research but,,,I forgot.

Love and gentle hugs,
Donna

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