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ASCO 2018 Cancer Research to Watch

ASCO 2018 Cancer Research to Watch

This week, YSC is traveling to Chicago for the American Society of Clinical Oncology (ASCO) meeting. This conference is the biggest oncology event in the U.S., with scientists from around the world presenting data. There’s a ton of data -- so much that it’s a little intimidating to dive into!

To help, YSC’s RISE Advocates have combed through the abstracts, and selected the research that they’ve identified as most relevant to young women affected by breast cancer and their co-survivors. Read on for their take on the news to watch.

The ASTRRA study

Role of adding ovarian function suppression to tamoxifen in young women with hormone-sensitive breast cancer who remain premenopausal or resume menstruation after chemotherapy: The ASTRRA study.

“The ASTRRA study, which is a collaboration of more than 10 universities and medical centers in South Korea, sought to assess the role of adding Ovarian Function Suppression (OFS) to tamoxifen (T) in young women with hormone-sensitive breast cancer. Researchers studied 1282 women (less than 45 years of age) who, after neoadjuvant chemotherapy, remained in a premenopausal status or who resumed ovarian function. The five-year disease-free survival (DFS) and overall survival of two groups, those who received T-only and those who received OFS + T, were evaluated. The ASTRRA study found that the estimated DFS rate at five years was 3.6% higher in the T + OFS group than the T-only group. In addition, the estimated overall survival rate after five years was 1.6% higher in the T + OFS group than the T-only group. The researchers concluded that adding two years of OFS to T, after neoadjuvant chemotherapy, significantly improved DFS for young women, with hormone receptor-positive breast cancer, who remain premenopausal or resume ovarian function.

This study is especially important for young women (below 45 years of age) with hormone-sensitive breast cancer. If these women remain premenopausal or resume ovarian function after receiving neoadjuvant chemotherapy, they should consider talking to their oncologist about their long-term treatment plan. The addition of Ovarian Function Suppression to tamoxifen may hold significant benefit for the patient.” - Decca Knight, RISE Advocate

Vaginal laser to improve symptomatic vulvovaginal atrophy and sexual function in breast cancer patients: Report from LAAVA pilot study.

“Every time the discussion of sex comes up, I think back to the Salt N Pepa Song from the 90's – Let’s Talk About Sex.  So, when I saw that a poster was created for ASCO 2018 to talk about sex or more specifically: “Vaginal laser to improve symptomatic vulvovaginal atrophy and sexual function in breast cancer patients,” my interest was piqued.

When you're going through breast cancer, the discussion on the effects from having ER+ breast cancer and sex doesn't always come up between doctor and patient.  However, in my YSC support groups, we talked about it all the time.  I always felt like until now, I just had to ‘deal’ with it.  However, with posters and research studies like this from the LAAVA pilot, it sounds like there are new options for all of us.  The LAAVA pilot recruited post-menopausal women but as we know as young survivors, this can affect us too. After three laser treatments, the patients reported significant improvement in all 5 areas (dryness, itch, burning, pain during urination and or pain during sex) and sexual function.  So this is an area for us all to keep an eye out and provides us with material we can take back to our doctors to determine if it’s a good solution for us.” - Rebecca Seago-Coyle, RISE Advocate

Smart Phone Study

Increasing adherence to adjuvant hormone therapy among breast cancer patients: A smart phone app-based pilot study.

“A cancer diagnosis brings more than emotional turmoil to a patient.  There is so much to remember in regards to treatment such as countless doctor appointments and medications to take.  Let’s not forget you still have to remember to continue on with your daily life activities. So, how does one keep track of everything?  In today’s culture, the cell phone is one of the most important tools we have to get us through everything in our daily life. So, wouldn’t it make sense to create an app to help breast cancer survivors remember their medications therefore leading to potentially better treatment results?  A team at Ohio State University has done just that.

They have started a pilot study inviting 39 breast cancer patients to try an app that reminds them to take their adjuvant hormone therapy (AHT) daily.  Reminders come daily via text message along with surveys to provide feedback on progress. Blood samples drawn throughout the study showed significant improvements in daily medication intake based on self-reporting from the patients.  Of the 39 initial participants 69.2% completed all the study requirements. The blood tests also showed reduction in estrogen hormone levels. 91.9% of the participants and 100% of the physicians participating in the pilot study found their participation to be beneficial.

The conclusion of the pilot study showed the participation in the app to be beneficial in improving health and quality of life in patients affected by hormone positive breast cancer.  Larger randomized studies will be the next step.

The significance of this study is the positive benefits it can bring to those affected by breast cancer by supporting them in remembering to adhere to their medical team’s treatment requirements.  Therefore contributing to their own health improvement and quality of life during and after treatment.” - Dana Stewart, RISE Advocate

Managing Menopause

Survivors of ER-expressing operable breast cancer (ER+BC) generally do not receive hormone replacement therapy for menopausal symptoms due to concern about provoking recurrence of disease.

“Picture this.  You’re in an important meeting and a massive internal fire spontaneously erupts.  Sweat is pouring out of every pore. Maybe you pull out a fan from your purse. Maybe you grab a handkerchief. Perhaps you literally just sweat it out. For premenopausal women diagnosed with breast cancer this is a common reality.  Chemotherapy interferes with ovarian function. If you have hormone positive (HR+) breast cancer (BC), you’ll be on some type of endocrine therapy.  If your cancer was HR+, addressing hot flashes can be a big challenge and women do not usually receive any type of hormone replacement due to concerns about provoking recurrence.  Several antidepressants (e.g. venlafaxine) have shown anecdotal evidence of helping with hot flashes in the off label setting.

Researchers at the Mayo Clinic are trying to better understand whether the most effective non-estrogen strategy for managing hot flashes, single dose depomedroxyprogesterone acetate (MPA), impacts survival in HR+BC patients.  At ASCO this year, Dr. Natalie Ertan-Archambault and colleagues reveal results from a 92 patient study evaluating local-regional recurrent free survival. Patients in the retrospective trial had received a single dose MPA (400mg IM), were matched 1:1 with contemporaneous controls, and followed for approximately 5 years.  Estimated 10 year local-regional recurrent free survival was approximately 85% in patients who received single dose and 95% for controls. Estimated event free survival at 10 years was 81% in cases and 76% in controls. The investigators conclude that in this retrospective, case control study, no detrimental effect of single dose MPA in survivors of HR+BC.

This study addresses an important need and concern for women with HR+BC and the results are encouraging; however, larger studies following patients longer than 10 years are needed to increase confidence among patients and medical oncologists.” - Michele Hille, RISE Advocate

Want to know more? Follow the hashtag #ASCO18 for up-to-the-minute news from the conference - or check out ASCO’s Featured Voices for a more curated feed.