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Breast Cancer to Make Big Jump in U.S. but Some Encouraging Research News

Cancer researchers hear fasting may lower risk, combo drug may break breast cancer resistance, more below; increase in senior women over 70

April 20, 2015 – The bad news about breast cancer is there are expected to be a 50 percent increase in U.S. cases by 2013, compared to 2011, according to research presented at a meeting of the American Association for Cancer Research. But there was also a ton of good news among the many research reports being presented that have found encouragement in the fight against this killer of women – primarily senior women.

This increase in cases is driven mostly by a marked increase in cases of women older than 70 and in estrogen receptor (ER)–positive tumors, according to research presented here at the American Association for Cancer Research (AACR) Annual Meeting 2015. Interestingly, proportion of new breast cancer cases among women ages 50 to 69 is expected to decrease.

“Managing this clinical burden will present a huge challenge,” said Philip S. Rosenberg, PhD, a senior investigator in the division of cancer epidemiology and genetics at the National Cancer Institute (NCI).

“The one silver lining is that we expect fewer ER–negative tumors, which include the most difficult-to-treat HER2-positive and triple-negative subtypes.”

According to Rosenberg, during the next several decades, 40 million American women who were born between 1946 and 1964 will face high absolute risks for postmenopausal breast cancer, which for the average woman is estimated to be 2 percent to 4 percent over a 10-year period.

Cancer: The Emperor of All Maladies – PBS TV

The AACR is a production supporter of the PBS documentary CANCER: THE EMPEROR OF ALL MALADIES, airing nationwide Monday, March 30 through Wednesday, April 1, 9 p.m. Produced by Ken Burns and based on the Pulitzer Prize-winning book by Siddhartha Mukherjee, MD, PhD, the film interweaves a sweeping historical narrative with intimate stories about contemporary patients and an investigation into the latest scientific breakthroughs that may have brought us, at long last, to the brink of lasting cures.

An additional 56 million women, most of them currently in their 20s and 30s, will be at substantial risk of premenopausal breast cancer, averaging 0.4 percent to 1.5 percent over a 10-year period.

With this study, Rosenberg and colleagues wanted to estimate the future incidence and burden of new cases of breast cancer according to in-situ, invasive, and ER status, in order to help the oncology community develop a proactive roadmap to optimize prevention and treatment strategies.

To do this, the researchers used nationally representative cancer surveillance data from the NCI Surveillance, Epidemiology, and End Results Program, population projections produced by the Census Bureau, and mathematical forecasting models to project the future numbers of breast cancer cases in the United States from 2011 to 2030. Because screening mammography has been well-accepted in the United States, the researchers forecast rising numbers of both invasive and in-situ tumor diagnoses, which are almost entirely detected via screening mammography.

The total number of new breast cancer cases classified as invasive and in-situ is expected to increase by about 50 percent from 283,000 in 2011 to 441,000 in 2030. Rosenberg and colleagues forecast that although the proportion of new breast cancer cases among women ages 50 to 69 is expected to decrease from 55 percent in 2011 to 44 percent in 2030, the proportion of cases in women ages 70 to 84 is expected to increase from 24 percent to 35 percent.

Data from the study forecast that the proportion of ER-positive invasive cancers will remain at about 63 percent; the proportion of ER-positive in-situ cancers, most of which are detected through screening mammography, will increase from 19 percent to 29 percent.

In contrast, the researchers forecast that the proportion of ER–negative cancers, both invasive and in-situ, will decrease from 17 percent of all tumors in 2011 to 9 percent in 2030. “The reasons for this decline remain unclear, but there are intriguing clues. For example, early age at first birth in the absence of breast-feeding is a particularly strong risk factor for early onset of ER-negative tumors. We know that in recent years, women have been delaying births and breast-feeding more often, both of which might partly explain the decline in this type of breast cancer,” Rosenberg explained.

“In sum, our results suggest that although breast cancer overall is going to increase, different subtypes of breast cancer are moving in different directions and on different trajectories,” Rosenberg said. “These distinct patterns within the overall breast cancer picture highlight key research opportunities that could inform smarter screening and kinder, gentler, and more effective treatment.”

This research was supported by the Intramural Research Program of the National Institutes of Health. Rosenberg declares no conflicts of interest.


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Extended Overnight Fasting May Lead to Reduced Breast Cancer Risk

Women in the study fasted for an average of 12.4 hours each night

A decreased number of hours spent eating each day and an increased number of hours spent fasting overnight may reduce a woman’s risk for breast cancer by improving biomarkers of glycemic control, according to research presented here at the AACR Annual Meeting 2015, April 18-22.

This study is being published simultaneously in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

“We found that women who fasted for longer periods of time overnight had significantly better control over blood glucose concentrations and these effects were independent of how much they ate,”  said Catherine Marinac, a doctoral candidate in public health at the University of California, San Diego. “This finding is relevant to cancer research because people who have poor glucose control are more likely to develop certain types of cancer, and it is hypothesized that high concentrations of circulating glucose may fuel cancer growth and progression.

“If these findings are reproduced, it would mean that increasing the duration of overnight fasting could be a novel strategy to reduce the risk for developing breast cancer,” Marinac added. “This is a simple dietary change that we believe most women can understand and adopt, and it may have a big impact on public health.”

According to Marinac, research in mice has suggested that decreasing the number of hours spent eating during the day and increasing the length of time of fasting overnight may improve metabolic parameters and reduce the risk of developing a number of chronic diseases including cancer. To explore this association further in humans, Marinac and colleagues looked at possible associations between the duration of nighttime fasting and glycemic control biomarkers that are linked to increased breast cancer risk.

The researchers found that for each three-hour increase in nighttime fasting, women had a 4 percent lower two-hour postprandial blood sugar measurement, which measures blood sugar two hours after starting a meal, and a nonsignificant 0.4 unit decrease in hemoglobin A1c (HbA1c), a measure of blood sugar control. Each three-hour increase in nighttime fasting was also associated with about 20 percent reduced odds of having elevated HbA1c and nonsignificantly reduced odds of an elevated two-hour postprandial blood sugar measurement.

“Our group is hoping to gain funding for a large-scale trial to confirm these findings,” Marinac said.

The study included data from a sample of women with a median age of 47 years taken from the 2009-2010 United States National Health and Nutrition Examination Survey. Data on HbA1c over the previous two to three months were available for 2,212 women. Data on two-hour postprandial blood sugar were available for 1,066 women.

This study was funded by the National Cancer Institute. Marinac declares no conflicts of interest.

New Drug Combination Shows Promise for Breaking Breast Cancer Resistance

A new combination of drugs which could overcome treatment resistance and relapse in breast cancer has been developed by researchers from The University of Manchester working with drug development company Evgen Pharma.

In research trevealed at the American Association of Cancer Research annual conference on Monday, the researchers show that in the most common type of breast cancer, affecting 70% of patients, the drug Sulforadex helps overcome resistance to routinely used hormonal treatments by targeting the cancer stem cell population.

While most women initially respond well to hormonal treatment with drugs such as tamoxifen, many go on to develop resistance and relapse. There is evidence that this is often due to activation of the Wnt signalling pathway, a gene involved in development which fuels the growth of the tumour.

Around 70% of breast cancers express the ‘estrogen receptor’ (ER) and typical treatment focuses on reducing estrogen levels or blocking ER function. However, the researchers have shown that cancer stem cells which cause tumours to regrow and spread do not express the ER. Thus, these stem cells aren’t inhibited by the standard treatments and have the ability to regrow the tumour.

The new combination therapy, tested in lab studies by the Manchester scientists, combines Evgen’s Wnt pathway-suppressing drug, Sulforadex with standard hormonal treatments. This targets both the estrogen-sensitive cells and the remaining cancer stem cells at the same time.

Dr Robert Clarke from the University’s Institute of Cancer Sciences said: “The hormonal therapies we use today are very good at treating breast cancer tumours driven by estrogen.

“However, they don’t completely solve the problem. This combination of drugs potentially allows us to target estrogen-sensitive cells, whilst also mopping up the cells which cause treatment resistance.”

The study was carried out in lab samples of treatment resistant cells from breast cancer patients. The next step will be to recruit patients for a trial in the next few months.

Dr David Howat, Head of Research and Development at Evgen Pharma said: “We are really excited about the data presented at the AACR. Dr Rob Clarke and his excellent research team have demonstrated the efficacy of Sulforadex in patient derived cancer tissues in vitro and, importantly, in an in vivo setting.

“We now intend to extend this collaboration and advance Sulforadex into a clinical trial with breast cancer patients.”

More Research Reports:

   ● New Antibody-Drug Conjugate Shows Early Promise for Patients With Metastatic HER2-positive Breast Cancer

April 20, 2015 PHILADELPHIA — An investigational antibody-drug conjugate called MM-302 was safe, tolerable, and showed signs of clinical activity in heavily pretreated patients with metastatic, HER2-positive breast cancer, according to data from a phase I clinical

   ● Investigational ER Degrader Safe, With Early Signs of Antitumor Activity Against Advanced ER-positive Breast Cancer

April 20, 2015 PHILADELPHIA — The new investigational estrogen receptor (ER) degrader GDC-0810 was safe and tolerable in postmenopausal women with advanced ER-positive breast cancer, and a subset of the women, all of whom were previously treated with standard endo

   ● New SU2C-OCRF-OCNA-NOCC Ovarian Cancer Dream Team Announced; $6 Million Grant Over 3 Years Will Focus on DNA Repair Therapies

April 20, 2015 PHILADELPHIA — Stand Up To Cancer (SU2C), Ovarian Cancer Research Fund (OCRF), Ovarian Cancer National Alliance (OCNA), and National Ovarian Cancer Coalition (NOCC), along with the American Association for Cancer Research (AACR), Scientific Partner

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