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Why We Don’t Have the Answers to Cure Breast Cancer

Wed, 03 May 2023 07:30:00 GMT

I purposely titled this as a statement rather than a question because most often the question is what we hear without any answers. I have been spending lots of time and effort in trying to find some of those answers and I think that I am finally beginning to have an understanding of this matter and believe me, there are no simple answers.

I know that I have heard people say over and over that scientists probably have the answers but they don’t want to share them because then they would be out of a job. If the solutions are found, then all of the huge amounts that are currently being raised will go away and all of those who run the big organizations won’t have the big bucks that they are currently using to line their pockets. After all, if you look at the whole picture that money isn’t being raised just during Breast Cancer Awareness Month but throughout the whole year so you would think that with so many brilliant minds doing all of this research, there certainly must be an answer by now. Well, nothing could be further from the truth but let me explain.

The biggest thing that I learned is that every single cancer has its own DNA. Even tumors from the same person, as I discovered in my own case, from two separate cancers had to be tested separately to determine their individual makeup. So, starting with this premise, how could a “one size fits all” answer cover all of the variations? In two simple words, it can’t. Then there is the fact that there are so many different types of breast cancer. That fact only increases the number of solutions needed in order to treat each different type of cancer that has its individual DNA in its individual tumors. Needless to say, it soon becomes very obvious that an immense number of treatments are needed to treat any combination of these factors in order to prolong the life of a breast cancer patient.

There are so many drugs and treatments on the market currently that are used alone or in combinations. The challenge is to find the right combination for treatment of each person. What appears to be the perfect solution for one person may be of no benefit to another that appears to have the same type of cancer. Then there are those cases where a particular combination that has been working for a patient for months and maybe even years stops working. That is what happens to a person whose cancer has been in remission and now has returned. In such cases, new combinations of chemo drugs are tried and perhaps nothing seems to work or only works for a couple of months or the side effects are so bad that a person can’t continue on a certain regimen.

These examples only begin to scratch the surface of what goes on in the breast cancer world. Based upon what I have learned, I believe that everyone who is working to raise money for breast cancer research either as an individual or major corporation or who has studied to become a researcher was driven to their work because of an intimate association with someone who dealt with this disease. I can’t begin to imagine anyone holding out on a cure or a solution after these people have seen the havoc that has been wreaked upon those around them and on others throughout the world. I don’t believe that there is anyone who doesn’t want to find the answers so that their family members and those of the generations to come will never have to know what breast cancer can do. After all, if someone does find the answer to a cure for breast cancer, there are plenty of other cancers out there for which they can work to find a cure.

The post Why We Don’t Have the Answers to Cure Breast Cancer appeared first on Let Life Happen .

Every new day …

Wed, 03 May 2023 07:15:00 GMT

“Every new day is a dawn of a new divine order.”

– Lailah Gifty Akita

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Partial Breast Irradiation Versus Whole Breast Irradiation for Early Breast Cancer Patients in a Randomized Phase III Trial

Wed, 03 May 2023 07:05:00 GMT

By: Birgitte V. Offersen, MD, PhD; Jan Alsner, MSc, PhD; Hanne M. Nielsen, MD, PhD; Erik H. Jakobsen, MD; Mette H. Nielsen, MD, PhD; Lars Stenbygaard, MD; Anders N. Pedersen, MD, PhD; Mette S. Thomsen, MSc, PhD; Esben Yates, MSc; Martin Berg, MSc; Ebbe L. Lorenzen, MSc, PhD; Ingelise Jensen, MSc; Mirjana Josipovic, MSc, PhD; Maj-Britt Jensen, MSc; and Jens Overgaard, MD, DMSc; on behalf of the Danish Breast Cancer Group Radiotherapy Committee – Journal of Clinical Oncology

From: medpagetoday.com

Purpose

On the basis of low risk of local recurrence in elderly patients with breast cancer after conservative surgery followed by whole breast irradiation (WBI), the Danish Breast Cancer Group initiated the noninferiority external-beam partial breast irradiation (PBI) trial (ClinicalTrials.gov identifier: NCT00892814 ). We hypothesized that PBI was noninferior to WBI regarding breast induration.

Methods

Patients operated with breast conservation for relatively low-risk breast cancer were randomly assigned to WBI versus PBI, and all had 40 Gy/15 fractions. The primary end point was 3-year grade 2-3 breast induration.

Results

In total, 865 evaluable patients (434 WBI and 431 PBI) were enrolled between 2009 and 2016. Median follow-up was 5.0 years (morbidity) and 7.6 years (locoregional recurrence). The 3-year rate of induration was 9.7% for WBI and 5.1% for PBI ( P =0.014). Large breast size was significantly associated with induration with a 3-year incidence of 13% (WBI) and 6% (PBI) for large-breasted patients versus 6% (WBI) and 5% (PBI) for small-breasted patients. PBI showed no increased risk of dyspigmentation, telangiectasia, edema, or pain, and patient satisfaction was high. Letrozole and smoking did not increase the risk of radiation-associated morbidity. Sixteen patients had a locoregional recurrence (six WBI and 10 PBI; P =0.28), 20 patients had a contralateral breast cancer, and eight patients had distant failure (five WBI and three PBI). A nonbreast second cancer was detected in 73 patients (8.4%), and there was no difference between groups.

Conclusion

External-beam PBI for patients with low-risk breast cancer was noninferior to WBI in terms of breast induration. Large breast size was a risk factor for radiation-associated induration. Few recurrences were detected and unrelated to PBI.

Read an interview about the study here .

Read the full article

Partial Breast Irradiation Versus Whole Breast Irradiation for Early Breast Cancer Patients in a Randomized Phase III Trial

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Early-Stage Triple-Negative Breast Cancer: Optimizing Therapy

Mon, 01 May 2023 07:05:00 GMT

By: Caroline Helwick

From: ascopost.com

The management of early-stage triple-negative breast cancer has been evolving at a fast pace, thanks largely to the discovery that immune checkpoint blockade can be effective in this subtype. At the 2023 Miami Breast Cancer Conference, Priyanka Sharma, MD , Professor of Medicine, University of Kansas Medical Center, took a sweeping look at the data that support current management, along with clinical nuances in practice and unanswered questions. ¹

How Beneficial Are Platinum Agents?

“Platinum agents have been of interest in triple-negative breast cancer for quite some time and have been studied in the context of neoadjuvant trials. The majority of the studies have added carboplatin to an anthracycline-containing regimen, and all have demonstrated improvement in pathologic complete response rates, but this has come at the expense of increasing toxicity,” she said.

Dr. Sharma reviewed several of the key studies of platinum agents in the neoadjuvant setting, starting with the large BrighTNess trial. ² The three-arm study with an anthracycline, cyclophosphamide, and a taxane (AC → T) backbone evaluated the addition of carboplatin as well as the addition of carboplatin plus low-dose veliparib. Carboplatin increased the pathologic complete response rate over AC → T alone, but veliparib did not. Similarly, the addition of carboplatin, but not veliparib, improved event-free survival—by an absolute 11%.

In a phase III study from Tata Memorial Hospital in India, the addition of a platinum to the neoadjuvant AC → T backbone proved beneficial. ³ Of note, compared with other trials, this study had higher proportions of patients younger than age 50 and with a high disease burden. For both event-free and overall survival, the majority of carboplatin’s benefit was in patients aged 50 and younger. In this age group, the addition of carboplatin led to a 12.5% absolute increase in event-free survival (hazard ratio [HR] = 0.642; P = .004) and an 11.2% increase in overall survival (HR = 0.611; P = .003).

“The reasons for carboplatin’s preferential activity in younger vs older patients is not clear. Perhaps treatment compliance and treatment completion rates differed. Perhaps the biology is different for younger vs older patients—older patients may be more likely to have a nonbasal phenotype and, hence, less benefit from carboplatin. We’ll see if the findings hold true in other platinum studies,” Dr. Sharma commented.

An anthracycline-free regimen, on the other hand, was the backbone used in the phase II NeoSTOP study, which Dr. Sharma led. ⁴ Patients received eight cycles of a four-drug regimen—carboplatin/paclitaxel followed by doxorubicin/cyclophosphamide (CbP → AC)—or six cycles of a two-drug regimen of carboplatin/docetaxel (CbD). Pathologic complete response rates were similar, 54% per arm, and the rates of residual cancer burden 0+1 were also similar at 67%. The study was not powered to look at long-term outcomes, but event-free and overall survival appeared comparable. The two-drug CbD regimen was associated with a more favorable toxicity profile and lower treatment-related costs, she reported.

Numerous investigations over the years have sought biomarkers of response to chemotherapy. Some factors have indicated general chemosensitivity—including tumor-infiltrating lymphocytes, homologous recombination deficiency, immune signatures, proliferation signatures, and even germline BRCA status. However, to date, none has helped in selecting or excluding patients for treatment, she said.

Immunotherapy for Triple-Negative Disease

Data from four key trials support the use of immune checkpoint blockade in early-stage triple-negative breast cancer: KEYNOTE-522, GeparNuevo, IMpassion031, and NeoTRIPaPDL1. All reported numer ical or statistically significant improvements in pathologic complete response rates. Event-free survival outcomes have been reported for KEYNOTE-522 and GeparNuevo but are pending for the other trials.

The results of KEYNOTE-522 ⁵ led to the 2021 approval by the U.S. Food and Drug Administration (FDA) for pembrolizumab in combination with chemotherapy as neoadjuvant therapy, continuing as adjuvant therapy in high-risk cases of triple-negative breast cancer. Pembrolizumab was given with paclitaxel and carboplatin, then with doxorubicin/ epirubicin and cyclophosphamide. Patients received 1 year of pembrolizumab, regardless of residual disease status. The absolute improvement in pathologic complete response rate was 7.5% at the time of pem brolizumab’s approval, ⁶ but it was larger (14%) in the original analysis. ⁵ Event-free survival at 3 years was improved with pembrolizumab by 7.7% (HR = 0.63; P = .00031).

GeparNuevo was a smaller phase II trial that evaluated the addition of durvalumab to taxane/anthracycline-containing chemotherapy. ⁷ The 9.2% numerical improvement in pathologic complete response rate was not statistically significant ( P = .287); however, the secondary endpoint of invasive disease–free survival did demonstrate a significant 8.4% absolute improvement with durvalumab (HR = 0.48; P = .0398). Patients received all immunotherapy preoperatively and did not receive adjuvant durvalumab.

Although KEYNOTE-522 and GeparNuevo used anthracycline-based chemotherapy as the backbone for immunotherapy, the NeoPACT trial, presented by Dr. Sharma at the 2022 ASCO Annual Meeting, ⁸ evaluated the non–anthracycline-containing regimen of carboplatin/docetaxel plus pembrolizumab. An encouraging pathologic complete response rate of 58% was reported in this single-arm study, and rates exceeded 75% for patients with immune-enriched tumors.

Based on these results, SWOG 2212 (SCARLET) will compare the KEYNOTE-522 regimen with the NeoPACT regimen with event-free survival as the primary endpoint. This important study is joined by several others with pending outcomes in the neoadjuvant and adjuvant settings, including:

“We await their results, as they will frame the future treatment algorithm for patients with early-stage triple-negative breast cancer,” Dr. Sharma commented.

Predicting Benefit to Avoid Unnecessary Toxicity

“The addition of immunotherapy to chemotherapy definitely improves outcomes for patients with early-stage triple-negative breast cancer, but it does come at the cost of toxicity,” Dr. Sharma acknowledged. Immune-related adverse events of any grade have been reported in up to 44% of patients with triple-negative disease, and grades 3 to 5 have been seen in up to 15%. Some effects, such as the endocrinopathies, can be permanent and life-altering, she noted.

For the selection of patients most likely to benefit from immunotherapy, many biomarkers have not panned out, but some that show more promise are emerging. Factors that have not proven predictive of benefit from immunotherapy in early-stage triple-negative breast cancer include PD-L1, tumor-infiltrating lymphocytes, tumor mutational burden, and several immune signatures. Although some of these factors may predict a response to neoadjuvant chemoimmunotherapy, they do not predict for a preferential response to the addition of the checkpoint inhibitor to chemotherapy, Dr. Sharma said.

There have been promising results with the DetermaIO, a 27-gene test that measures both tumor gene expression and tumor immune microenvironment. The DetermaIO score has been associated with preferential benefit from neoadjuvant atezolizumab plus chemotherapy over chemotherapy in NeoTRIP and was associated with pathologic complete response in NeoPACT. Expression of major histocompatibility complex II (MHC-II) on tumor cells has also been correlated with pathologic complete response with neoadjuvant chemotherapy plus durvalumab or pembrolizumab but not to neoadjuvant chemotherapy alone—with some association with event-free survival noted as well.

“We have seen some encouraging results with a couple of biomark ers, and we await their evaluation in larger trials,” she commented.

Adjuvant Treatment of Residual Disease

For patients with residual disease after neoadjuvant therapy, the CREATE-X trial established the administration of six to eight cycles of capecitabine as beneficial in reducing recurrence risk (HR = 0.58; P = .01) and death (HR = 0.60; P = .01). ⁹ Adjuvant capecitabine, therefore, is a standard recommendation for patients with residual disease.

For patients with germline BRCA mutations and high-risk features, the OLYMPIA trial established the benefit of 1 year of adjuvant ther apy with olaparib, a PARP inhibitor, based on an 8.8% improvement in 3-year invasive disease–free survival (HR = 0.58; P < .001) and a 3.8% improvement in overall survival (HR = 0.68; P = .009). ¹⁰

“Olaparib is certainly a very effective option for patients who have germline BRCA- mutated triple-negative breast cancer and residual disease after preoperative chemotherapy or who start out with stage II or III disease and receive surgery first,” Dr. Sharma said.

Pathologic Response: Highly Prognostic

“It has now been established that pathologic response is highly prog nostic, and patients with triple-negative breast cancer who achieve a pathologic complete response do very well. Such patients do not benefit from further adjuvant chemotherapy,” Dr. Sharma said.

In the setting of a pathologic complete response, therefore, is adjuvant pembrolizumab warranted? In KEYNOTE-522, patients who achieved a pathologic complete response had good outcomes regardless of whether they received the checkpoint inhibitor, with a 3-year event-free survival rate of greater than 92% in both arms. In contrast, for patients lacking a pathologic complete response, more than 30% in either arm experienced an event after neoadjuvant therapy.

“This begs the question: what is the absolute benefit for continuing pembrolizumab in patients with pathologic complete response?” Dr. Sharma asked. “The phase III OptimICE-pCR trial will seek to answer this question in a randomized fashion.”

Other Knowledge Gaps

“Finally, we have made significant progress in treating early-stage triple-negative breast cancer, but knowledge gaps certainly still remain,” Dr. Sharma concluded. She offered questions to be answered, and some of the clinical trials attempting to do so:

Should all patients be treated with three- to four-drug chemother apy regimens when immune checkpoint blockade is included as neoadjuvant systemic therapy? With checkpoint blockade on board, can chemotherapy be de-escalated (SWOG 2212)? Could dose-dense AC be used with checkpoint blockade? What is the role of adjuvant checkpoint blockade when these drugs are not used in the neoadjuvant setting? What about in the setting of residual disease (SWOG 1418) or pathologic complete response (OptimICE-pCR)?

Do all patients need chemotherapy and immune checkpoint blockade? Can patients who are unlikely to benefit be identified, and can “cold” tumors be made “hot”? From the patient perspective, what are the long-term side effects of checkpoint blockade in the curative setting? Are there predictors of toxicity, and what is the impact on fertility?

REFERENCES

1. Sharma P: Optimal systemic therapy for early-stage triple-negative breast cancer. Invited Lecture. 2023 Miami Breast Cancer Conference. Presented March 3, 2023.

2. Loibl S et al: Addition of the PARP inhibitor veliparib plus carboplatin or carboplatin alone to standard neoadjuvant chemotherapy in triple-negative breast cancer (BrighTNess). Lancet Oncol 19:497-509, 2018.

3. Gupta S et al: Addition of platinum to sequential taxane-anthracycline neoadjuvant chemotherapy in patients with triple-negative breast cancer. 2022 San Antonio Breast Cancer Symposium. Abstract GS5-01. Presented December 9, 2022.

4. Sharma P et al: Randomized phase II trial of anthracycline-free and anthracycline-containing neoadjuvant carboplatin chemotherapy regimens in stage I-III triple-negative breast cancer (NeoSTOP). Clin Cancer Res 27:975-982, 2021.

5. Schmid P et al: Pembrolizumab for early triple-negative breast cancer. N Engl J Med 382:810-821, 2020.

6. Schmid P et al: Event-free survival with pembrolizumab in early triple-negative breast cancer. N Engl J Med 386:556-567, 2022.

7. Loibl S et al: A randomised phase II study investigating durvalumab in addition to an anthracycline taxane-based neoadjuvant therapy in early triple-negative breast cancer. Ann Oncol 30:1279-1288, 2019.

8. Sharma P et al: Clinical and biomarker results of neoadjuvant phase II study of pembrolizumab and carboplatin plus docetaxel in triple-negative breast cancer (NeoPACT). 2022 ASCO Annual Meeting. Abstract 513.

9. Masuda N et al: Adjuvant capecitabine for breast cancer after preoperative chemotherapy. N Engl J Med 376:2147-2159, 2017.

10. Tutt ANJ et al: Adjuvant olaparib for patients with BRCA1- or BRCA2-mutated breast cancer. N Engl J Med 384:2394-2405, 2021.

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Breast Cancer and Helping Others

Sat, 29 Apr 2023 08:00:00 GMT

I have been thinking about “how did you react when someone tells you that they have cancer. As we all know, that is a really hard subject with which to deal. Over the years I was faced with someone having cancer that has included my grandfather, my godmother, her daughter and granddaughter along with my father, my mother, my sister, my baby brother and numerous friends to that list. And now that I have been on the receiving end of cancer as well, I have learned so very much. But, most importantly, I have learned that each person and how they choose to deal with their own cancer is as individual and different as their own cancer and treatment.

I believe that the best thing that anyone can do for someone with cancer is to respect them. This includes respecting how they choose to deal with their own situation, the choices that they make with regard to treatment, etc. regardless of whether you agree or disagree with those choices and what they choose to share or not share. We are all unique because of not only our creation but also because of our own experiences. We have been given the right to do what we feel is best for ourselves on an individual basis and no one has the right to tell us what we should do with our own lives.

From there, if you let the cancer patient know that you are there to help them in any way that they may wish (taking them to dr. appointments, picking up food or prescriptions, bringing in a meal, helping out with children in the household, etc.), just know that the matter is now out of your hands. You can be there to listen or just sit quietly as needed. You can make a call to find out if there is any way in which you are able to assist and from there it is up to the patient. Allowing the patient this type of control over their own life is the only control that they will have in this matter and it makes all of the difference in the world. I know that it made all of the difference to me in my own battle.

Please also know that the reason for this website is for all of us to have a place where we can share our experiences, our questions and a fellowship with others who are going through their own struggles regardless of what they may be. You are always welcome here and know that the others here feel as I do and that is that we are all in this together and that is why we are here to help each other.

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Treatment in HR+ Early Breast Cancer May be Best Guided by Risk of Recurrence

Thu, 23 Mar 2023 07:05:00 GMT

By: Caroline Seymour

From: onclive.com

After settling the debate of which patients with early-stage, hormone receptor–positive breast cancer require chemotherapy in addition to endocrine therapy, investigators have set their sights on determining whether ovarian function suppression can deliver the same effects of chemotherapy and when to recommend abemaciclib (Verzenio) and olaparib (Lynparza).

In the footnotes of the National Comprehensive Cancer Network (NCCN) guidelines for adjuvant endocrine therapy new guidance indicate that abemaciclib may be considered in combination with endocrine therapy in patients with hormone receptor–positive, HER2-negative, high-risk disease with at least 4 positive lymph nodes or 1 to 3 positive lymph nodes with grade 3 disease, a tumor size of at least 5 cm, or a Ki67 score of 20% or higher. Moreover, olaparib may be considered in the BRCA -mutant population; chemotherapy should be given in combination with endocrine therapy in premenopausal patients; and 5 years of an aromatase inhibitor or tamoxifen plus ovarian function suppression can be considered for premenopausal patients at higher risk of recurrence. ¹

The recommendations are based on data from the TAILORx (NCT00310180), RxPONDER (NCT01272037), SOFT (NCT00066690) and TEXT (NCT00066703), monarchE (NCT03155997), and OlympiA (NCT02032823) trials, which William J. Gradishar, MD, FASCO, FACP, reviewed in a presentation delivered at the 40th Annual Miami Breast Cancer Conference®. ² Gradishar is the Betsy Bramsen Professor of Breast Oncology and chief of Oncology/Hematology at the Robert H. Lurie Comprehensive Cancer Center at Northwestern University in Chicago, Illinois.

Tackling Treatment Intensity in TAILORx and RxPONDER

For women with an OncotypeDx recurrence score of less than 26, the importance of adding chemotherapy to endocrine therapy was shown in the phase 3 TAILORx trial. In the study, women with high-risk, node-negative, estrogen receptor (ER)–positive, HER2-negative breast cancer underwent testing with the OncotypeDx assay to determine risk of recurrence. Patients with a low score between 0 and 10 received endocrine therapy alone and those with a high score between 26 and 100 received endocrine therapy plus chemotherapy. Patients with a mid-range score between 11 and 25 were randomly assigned to endocrine therapy with or without chemotherapy.

Findings from an updated analysis presented at the 2022 San Antonio Breast Cancer Symposium ³ mirrored those presented in the primary analysis, showing that endocrine therapy alone (n = 3399) was noninferior to its use in combination with chemotherapy (n = 3312) in the intention-to-treat population. However, when further stratified by age, investigators showed improved invasive disease-free survival (iDFS) and distant recurrence-free survival (DRFS) in patients aged 50 years or younger and a recurrence score between 21 and 25 with the addition of chemotherapy.

“This begs the question of whether optimal endocrine therapy with ovarian suppression could achieve the same thing,” Gradishar said.

The phase 3 RxPONDER trial similarly evaluated the benefit of added chemotherapy, but in women with node-positive disease and a recurrence score between 0 and 25. Although results showed no statistically significant difference for iDFS in the postmenopausal population, premenopausal patients experienced a 5-year absolute difference in iDFS of 5.2% with chemotherapy (HR, 0.54; 95% CI, 0.38-0.76; P = .0004). ⁴

The ongoing BR009 trial will formally address whether chemotherapy has any advantages over ovarian function suppression with endocrine therapy in the premenopausal population, results of which will prove “very useful,” according to Gradishar.

“Based on the RxPONDER as well as the TAILORx trial, we now have tools that help define those patients who really need chemotherapy, and a significant chunk of them [for whom] we can avoid chemotherapy,” Gradishar said. “We’re still learning a great deal from certain subsets in these trials that will prove to be informative with further updates.”

Sorting Through Optimal Endocrine Therapy in SOFT and TEXT

“The SOFT and TEXT trials have been around for a long time, and we’ve heard data presented from them over the years. We now have very mature data from this dataset,” Gradishar said.

Both trials evaluated tamoxifen and exemestane in combination with ovarian function suppression in premenopausal patients. In both trials, adjuvant chemotherapy was permitted for patients at high risk per the treating physician. In data presented at the 2021 San Antonio Breast Cancer Symposium, the addition of ovarian function suppression to either tamoxifen or exemestane demonstrated clear benefit, with a 12-year overall survival (OS) rate of 89.0% and 89.4%, respectively, vs 86.8% with tamoxifen alone ( P = .06). ⁵ Moreover, in a joint analysis of both trials, exemestane plus ovarian function suppression showed a 3.3% improvement in OS benefit compared with tamoxifen and ovarian function suppression in the HER2-negative chemotherapy cohorts.

“Where that benefit was most evident is in patients who are deemed to have the highest risk. So, for those clinicians who decided chemotherapy should be part of the plan, often patients with higher-risk disease, clearly younger patients, [are the] group [for which] maximal ovarian suppression and endocrine therapy really showed the most benefit,” Gradishar said.

“The SOFT and TEXT trials have told us that in very high-risk patients, particularly those who are young with high-risk features, the addition of ovarian suppression plus endocrine therapy may further reduce the risk of recurrence. There are trials that are ongoing that will help define whether ovarian suppression plus endocrine therapy could serve as a substitute for chemotherapy with an equally good outcome,” Gradishar said.

Treating With Targeted Therapy in monarchE and OlympiA

“Transitioning to one of the newer wrinkles that we have in adjuvant endocrine therapy, and for that matter, endocrine therapy in general, is the notion of partnering endocrine therapy with targeted therapies,” Gradishar said.

A total of four trials evaluating CDK4/6 inhibitors have been performed in the adjuvant setting, but only one has proved positive to date: monarchE, which showed a 30% reduction in invasive disease with abemaciclib plus endocrine therapy vs endocrine therapy alone (HR, 0.70; 95% CI, 0.59-0.82; P < .0001). ⁶ Both the phase 3 PALLAS (NCT02513394) and PENELOPE-B (NCT01864746) trials, which evaluated postoperative palbociclib (Ibrance), failed to demonstrate statistical significance vs placebo for the primary end point of iDFS (HR, 0.96; 95% CI, 0.81-1.14; P =.65; HR, 0.93; 95% CI, 0.74-1.17; P = .53, respectively). ^7,8 Results from the phase 3 NATALEE trial (NCT03701334) are still pending.

monarchE enrolled patients with pre- or postmenopausal hormone receptor–positive, HER2-negative, node-negative, high-risk early breast cancer. “Keep in mind that these are high-risk patients who had certain features that allowed them to be participants in this trial, [such as] greater than 4 positive nodes, or 1 to 3 nodes with other features, including high-grade or larger tumors. There was a smaller cohort that was driven largely by proliferation or Ki67,” Gradishar said.

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Finding the Right Fit for Volunteering

Tue, 21 Feb 2023 04:08:54 GMT

So, you want to get involved in your community and make a difference, but you’re not quite sure where to start. There are plenty of causes you care about and important nonprofits that are working to change the world, but how can you find the right one for you?

While it might seem simple, choosing a nonprofit organization to volunteer with can actually be a very challenging decision. There are so many options to choose from, it might become overwhelming. Even if you care about a cause, how can you ensure you’re a good fit for the position? Here are some ideas to help you find the right fit for volunteering.

Find your passion.

The first—and most important—step to finding your fit for volunteering is to make sure it’s something you’re passionate about. There are a variety of worthy causes out there, but if you work with something you don’t genuinely care about, then you will waste both yours and the charity’s time. Make a list of groups, causes and issues that elicit a strong emotional response in you. For instance, perhaps you care a lot about the elderly because you were very close with your grandmother. Or, you love donating blood because you have a rare blood type. Write down the things you care about to evaluate your passions.

Consider your skills.

Next, consider what skills you have to offer in a volunteer position. Just because you have a passion for the cause doesn’t necessarily mean you would work well there. Nonprofit organizations want volunteers at their best, so evaluate what you’re good at and how you could use that in a volunteer role. For example, maybe you don’t love working with people, but you’re great with numbers, so you could help with financial services. Or, maybe you’re great at projects around the house, and could offer free services to fix up their building. Whatever your strengths are, you can leverage them to support a cause you care about.

Ask around.

Once you’ve identified what you love and what you’re good at, it’s time to investigate charities to work with. Of course, where’s the easiest place to start? With your family and friends! Ask the people around in your life to see if they know any nonprofits with valuable causes who could use an extra set of hands. If you’re still not sure, question those closest to you where they could see you volunteering. Sometimes an outside perspective is the best one we can gain on our lives, so ask where your loved ones think you should volunteer.

Search online.

There are a variety of online databases available for people interested in volunteering. Sites like VolunteerMatch, Idealist and HandsOn Network all have networks of organizations in need and volunteer positions available. Simply go to the site, type in your location and what you’re interested in, and surprise! You have a complete list of nonprofits in your area looking for volunteers like you. Give it a try to start you off on the right foot as you continue to pursue a valuable volunteer match.

Start small.

When you have connected with a charity, be sure to start small. You might not want to dive in right away. Instead, it’s perfectly fine to take some time to get your feet wet. Volunteer when and where you can, and see how you enjoy working with the organization. Once you feel more comfortable or confident in volunteering, there will be plenty of opportunities for you to get more involved. And of course, always be sure to organize your time well and avoid volunteer burnout.

Finding a cause to volunteer with can be a challenging decision. Between all of the available organizations and opportunities, how can you choose? Keep these tips in mind as you explore the nonprofit arena and search for your right fit for volunteering.

Know Your Lemons Teams Up With Curia To Save Lives

Mon, 20 Feb 2023 03:29:00 GMT

The award winning Know Your Lemons breast cancer early detection app is partnering with Curia, the award winning cancer patient navigation app. Cancer affects millions of people around the world and in 2020, breast cancer became the most common type of cancer globally. However, technology has made it easier to detect and treat cancer, with new apps and technologies being developed to help patients navigate through their cancer journey, from early detection through treatment and beyond.

Using lemons as a visual metaphor for breasts, the Know Your Lemons innovative early detection app educates patients about the early signs of breast cancer. Take the risk assessment text to get a customized screening plan based on your personal risks. Learn how and when to do a breast self-exam, guided by Mona Lisa or Napoleon. The app’s period tracker helps you know when is the best time to check your breasts based on your cycle (and doesn’t track any of your data!). Think you may have a symptom? Learn more about each symptom in detail, how to talk to your doctor about it, the different screening tools, and how to prepare for them.

By partnering with Know Your Lemons, Curia is taking a proactive approach to cancer treatment by encouraging patients to be more aware of their health, stay on top of surveillance, and take action when necessary.

The Curia Cancer App provides cancer patients with up-to-date information for their specific cancer types. By answering a series of questions about your cancer, Curia helps you find treatments that match your cancer profile and allows you to search and apply for nearby clinical trials directly from the app. The Curia app doubles as a connector to both experts and other cancer patients. Locate and contact the experts closest to you who specialize in your type of cancer. Find your ‘cancer twin’ and connect with up to 3 fellow cancer patients who share a similar cancer profile. Share, learn, support, and empower one another through a private chat.

Curia is partnering with the Know Your Lemons early detection app to help patients find their cancer early in order to have a better chance at survival.

The partnership between Curia and Know Your Lemons is a win-win for cancer patients around the world. Curia's cancer patients will benefit from the early detection and patient navigation tools provided by Know Your Lemons, while Know Your Lemons will be able to reach a wider audience through Curia's established network. Ultimately, this partnership will help to save lives around the world through breast cancer early detection, improving cancer outcomes for patients everywhere.

The Know Your Lemons Early Detection App and the Curia Cancer App are two powerful tools that can help cancer patients navigate through their cancer journey. By partnering together, they are able to provide patients with the knowledge, support, and guidance they need to survive and thrive. If you or someone you know is dealing with cancer, consider downloading both of these apps to take advantage of the many benefits they offer. Together, we can empower patients and save lives.

Pinkwashing

Tue, 11 Oct 2022 19:38:00 GMT

As a charity dedicated to early detection for breast cancer we help companies contribute meaningful impact for breast cancer awareness. First we will talk about what “pinkwashing” is and how we partner with companies to use funds and their platform to save lives with our innovative global education programs that address health inequities.

“Pinkwashing” is a term used to describe profits or services that turn pink as part of their sales promotions but contribute little or nothing to the cause through charitable giving and don’t participate in customer and employee education. Here is an example of how a breast cancer awareness promotion would differ from a Valentine’s promotion:

Valentine’s : show hearts, use pink and red, talk about loving and honoring those you care about by giving them a particular product or service.

Breast cancer awareness : include a pink ribbon, honor those who have faced the disease, invite customers and employees to be part of improving early detection, by financially contributing to a breast cancer charity a meaningful portion of the sale of a particular product or service and use the company platform to actively educate.

Sometimes companies treat breast cancer awareness “month” the same way they do a holiday rather than a social cause. Here’s how we work with companies to create more meaningful impact and be part of the lifesaving work we do to educate to improve early detection:

Our partnerships include two components:

This first piece is what makes us unique as a breast cancer organization. By having an education solution that allows companies to be an active part in addressing awareness by partnering with us to promote breast health information, it’s not just a campaign to hand off money to a charity that will then use it to benefit a separate group of people.

The way we educate has such appeal because it is designed in a universal and inclusive way, so it communicates effectively no matter the audience. Because we don’t use breasts and use the visual metaphor of lemons, we can be incredibly detailed in teaching symptoms, and avoid censorship issues that prevent companies from taking part in the education aspect.

Incredibly our partnership has the dual benefit of helping the audience and employees of the company through social media collaborations, product inserts, email communications, employee education packages, webinars AND those who are outside the scope of the company through our year-round efforts.

Second, corporate giving has many possibilities, ranging from:

1. Customer donations though rounding up at the till or adding their own donation during checkout

2. Matching employee and customer donations up to a certain amount

3. Offering a portion of sales during a specific time period or for a specific SKU on an ongoing basis

4. Creating a new SKU that includes a flat donation for each sale

5. A specified tax-deductible company donation

6. In-kind donations that offer tangible support to the mission

With any breast cancer awareness promotion there are some things to consider to ensure messaging and the intention to make an impact are aligned and considerate of the patient community and charity’s efforts:

Plan any promotions with the partner charity well in advance. We can advise on ways to optimize company efforts and how to be authentic to your brand and anticipate potential issues. Options of educating and ways to tie messaging with the brand is a collaborative process.

Consider doing more than just October. Show customers your ongoing support by highlighting the cause a few times a year or having a year-round offering.

Go into the partnership with a long term view. It can be typical of companies to look at a charity partnership as a one-off event around a particular month or product launch, but having a view to working year-round and over the space of several years allows the relationship to grow and the impact to expand. For example, when we work with companies to be active educators, it’s common that a customer or employee will get diagnosed earlier and as a result their life was literally saved because of the partnership. The results of that won’t be apparent in a week or a month, so ongoing efforts and community building are important, even just simple check-ins can go a long way.

Be considerate of the hardship patients face not only in dealing with trauma, but how breast cancer awareness promotions can be triggering. We work with you on understanding common mistakes companies make, such as talking about patients as heroes who have “fought” the disease and won. Saying these things implies that those who died didn’t fight hard enough. Cancer doesn’t cure itself just because someone is more determined. While perseverance is a necessary part of facing a trial and it’s a trait that should be admired, cancer outcomes are largely based on factors entirely outside the patient’s control. Their fate is not entirely in their hands and they should not be the only determinate for their recovery or viewed as someone who is a war hero—cancer is not a battle they signed up for. They didn’t enlist, they weren’t trained, they are simply someone who was pushed into a turbulent sea and are trying to keep their heads above water while people from the side cheer and say, “Wow! You are such a great swimmer, I just admire you for what you are doing.” They are swimming to stay alive, and whether they have arms flailing or have an impressive breaststroke is not something to be judged on. Patients feel a lot of pressure to be that beautiful swimmer with a satin pink ribbon. Whether that’s when they are in active treatment, recovery, survivorship, or “thrivership” (for those who have a lifelong form of breast cancer), as a charity partner we help companies navigate these issues in a considerate way.

We understand our partnership requires a little more from companies to commit to both educate and financially support the cause, and therefore we might not be a fit for everyone. As our mission states, we are dedicated to educating and are eager to work with those who want to be an active part in saving lives and truly want to make a difference, raising the bar from “awareness” and pink ribbons to lifesaving education, with a twist of lemon.