Reducing Breast Cancer Recurrence

The 2018 San Antonio Breast Cancer Symposium is currently underway. Trial results presented at the conference and published in the New England Journal of Medicine Dec. 5 show that a drug approved for metastatic breast cancer could also be used to treat some patients with early-stage disease. The KATHERINE trial focused on patients with HER2-positive breast cancer who had received chemotherapy and HER2-targeted therapy prior to surgery but who still had cancer remaining in the breast or armpit following the pre-surgery treatment. The researchers randomly assigned the patients to either receive a standard post-surgery treatment with Herceptin (trastuzumab) or to receive Kadcyla (trastuzumab emtansine). Based on the results, the researchers estimated that 88.3 percent of patients taking post-surgery Kadcyla would be alive without invasive disease three years after starting treatment, compared to 77 percent of patients on Herceptin. Kadcyla is made up of trastuzumab, which targets HER2-positive cells, and the chemotherapy drug emtansine. Kadcyla does come with a higher rate of side effects than Herceptin, the study authors note.

Living After CAR-T Cell Therapy

The U.S. Food and Drug Administration approved the CAR-T cell therapy Yescarta (axicabtagene ciloleucel) for certain patients with difficult-to-treat non-Hodgkin lymphoma in fall 2017, and the agency expanded approval in spring 2018 for a similar therapy, Kymriah (tisagenlecleucel), to treat this same group of patients. CAR-T cell therapies are immunotherapy drugs made up of modified immune cells isolated from patients’ own blood. Research presented at the American Society of Hematology Annual Meeting in San Diego and published in The Lancet Oncology and the New England Journal of Medicine provides follow-up data on the drugs. Researchers found that at a median of 2.25 years after treatment with Yescarta, 39 percent of patients still had ongoing responses to the drug and more than half were still alive. Meanwhile, researchers estimated that 1.5 years​ after treatment with Kymriah, the probability of survival is 43 percent.

Survivorship Care Plans Only Help Some Patients

Some cancer patients say they feel abandoned after their initial treatment ends. That’s why in 2005 the Institute of Medicine recommended that cancer patients be provided a survivorship care plan—a document summing up their treatment and outlining what follow-up care they should get. But studies of survivorship care plans haven’t shown that they increase patient quality of life. A study published Nov. 30 in Cancer may help explain why. Researchers randomized hospitals in the Netherlands to either provide a survivorship care plan or usual care to gynecologic cancer patients. They also classified patients based on whether they tended to cope by seeking or avoiding information. The researchers found that the patients with an information-seeking coping style were significantly happier with their care and the information given to them if they received a survivorship care plan. But those with an information-avoiding coping style reported more worry if they received a survivorship care plan. “The current study demonstrates that survivorship care plans may be beneficial for patients who desire detailed information about their cancer, whereas they may be less beneficial and perhaps even harmful for patients who prefer to avoid medical information,” the researchers conclude.

Immunotherapy Combo Approved

The U.S. Food and Drug Administration on Dec. 6 app​roved a new four-dru​g combination as initial treatment for patients diagnosed with metastatic non-squamous non-small cell lung cancer (NSCLC) without ALK or EGFR mutations. The combination includes the immunotherapy drug Tecentriq (atezolizumab), the targeted therapy Avastin (bevacizumab) and the chemotherapy drugs paclitaxel and carboplatin. Previously, Tecentriq was approved for metastatic NSCLC patients who had already received initial therapy and whose cancers had progressed. Keytruda (pembrolizumab), in combination or alone, is already approved as an initial treatment for some patients with metastatic NSCLC.​