XRAY — Behind the Metastatic Breast Cancer Headlines

FORCE’s eXamining the Relevance of Articles for You: Metastatic Breast Cancer (XRAY: MBC) looks behind the cancer headlines to bring you reliable information about metastatic breast cancer research-related news and information. XRAY: MBC reviews metastatic breast cancer research, provides plain-language and in-depth summaries, links to clinical trials, summarizes current guidelines and rates how well the media covered each topic. XRAY: MBC was made possible by the generous support of Novartis. 

Metastatic Breast Cancer

Read the topics we are discussing this month

Relevance: High

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Quality of Writing: High

10Quality of Writing

Personal Story: Running marathons with metastatic breast cancer? Yes!

Most relevant for: Women with metastatic breast cancer

Runner’s World Magazine featured Sarah Smith, a metastatic breast cancer patient who runs marathons and ultra-marathons. By telling her story, Sarah wants to encourage people to stay active, despite the challenges that life may bring. (10/13/19)

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Relevance: Medium-High

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Strength of Science: Medium

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Research Timeline: Post Approval

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Study: Inherited mutations In metastatic breast cancer patients

Most relevant for: People with metastatic breast cancer

Recent research shows that a significant portion of patients with metastatic breast cancer have harmful mutations in a gene associated with hereditary breast cancer and increased breast cancer risk. (9/26/19)

Relevance: Medium

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Research Timeline: Post Approval

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Guideline: FDA issues warning on CDK inhibitors

Most relevant for: People currently taking a CDK inhibitor

The U.S. Food and Drug Administration issued a safety alert for CDK inhibitors, including Ibrance (palbociclib), Kisqali (ribociclib), and Verzenio (abemaciclib). (9/24/19)

Relevance: High

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Strength of Science: Medium

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Research Timeline: Post Approval

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Study: Supportive care can improve quality of life for people with metastatic breast cancer

Most relevant for: People diagnosed with metastatic breast cancer

Metastatic breast cancer patients have unique needs for treatment and care. Connecting patients to appropriate support services and palliative care is an area of need in health care. A recent study reported improvement in metastatic breast cancer patient quality of life and wellness with an intervention program called the Supportive, Education and Advocacy (MBC-SEA) program. (8/21/19)

Relevance: High

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Strength of Science: High

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Research Timeline: Post Approval

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Study: CDK inhibitors may increase survival for ER-positive metastatic breast cancer patients

Most relevant for: People with metastatic, hormone-positive, Her2-negative breast cancer

The phase III MONALEESA-7 study is a clinical trial looking at the effect of a type of treatment known as a CDK4/6 inhibitor in pre- or perimenopausal women with hormone receptor–positive advanced breast cancer. (7/22/19) 

 

 

Relevance: High

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Research Timeline: Post Approval

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Guideline: FDA approves an immunotherapy treatment for some patients with triple-negative breast cancer

Most relevant for: People with metastatic, triple-negative breast cancer

The FDA approved the use of the immunotherapy drug atezolizumab (Tecentriq) in combination with the chemotherapy agent nab-paclitaxel (Abraxane) for certain patients with advanced triple-negative breast cancer. (5/26/19)

Relevance: Medium-High

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Strength of Science: Medium-High

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Research Timeline: Human Research

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Study: Smart drug shows promising results for treatment of metastatic triple-negative breast cancer

Most relevant for: People with metastatic, triple-negative breast cancer

We report results of an early-stage clinical trial of a new class of drugs for metastatic triple-negative breast cancer (TNBC). IMMU-132 is a combination of two different molecules: an antibody that targets certain types of cancer and delivers a chemotherapy drug that can kill cancer cells. This study looks at whether IMMU-132 is safe and effective for treating metastatic TNBC. (4/16/19)

Relevance: Medium-High

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Research Timeline: Post Approval

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Guideline: Breast surgeons recommend genetic testing for all breast cancer patients

Most relevant for: Anyone diagnosed with breast cancer

Summary: 

The American Society of Breast Surgeons published statement on genetic testing for hereditary breast cancer on February 10, 2019. It includes recommendations about who should be tested. Among these is the recommendation that all breast cancer patients get genetic testing, as well as women who do not have breast cancer but fit the National Comprehensive Cancer Network (NCCN) guidelines. (3/25/19)

Relevance: Medium-High

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Strength of Science: Medium-High

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Research Timeline: Post Approval

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Study: Prevalence of BRCA founder mutations in Bahamian women

Most relevant for: Bahamanian women

Summary:

The Bahamas has the highest known frequency of BRCA mutations among people diagnosed with breast cancer. This study reviewed whether population-based BRCA testing (testing everyone regardless of family or personal history of cancer) would be an effective approach for finding mutation carriers in the Bahamas. (3/4/19)

Relevance: Low

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Research Timeline: Lab Research

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Article: Promise of a cure for cancer is too good to be true

Most relevant for: People diagnosed with cancer

Summary:

The Jerusalem Post published an article titled, “A cure for cancer?  Israeli scientists may have found one.” The story profiled a small Israeli company called Accelerated Evolution Biotechnologies that has been working on developing new cancer treatments since 2000. The article relied almost entirely on an interview with the company’s chairperson of the board who made a series of unsubstantiated claims that included that, in a year’s time, the company will offer a complete cure for cancer. (2/12/19)

Relevance: High

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Quality of Writing: High

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Article: The cost of cancer care and impact of financial hardship on treatment

Most relevant for: Anyone diagnosed with cancer

Summary:

Several recent studies on the cost of cancer care show the negative effects on cancer patients. In this XRAYS we review a recent article by Kaiser Health News and associated studies about the financial impact of breast cancer treatment and cost of precision medicine. (2/8/19)

Relevance: High

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Strength of Science: Medium-High

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Research Timeline: Post Approval

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Study: The impact of palbociclib (Ibrance) on overall survival for metastatic breast cancer patients in the PALOMA-3 trial

Most relevant for: People with metastatic, hormone-positive breast cancer

Summary: 

The PALOMA-3 clinical trial showed that a new CDK4/6 inhibitor in combination therapy improved progression-free survival of women treated for hormone receptor-positive, HER2-negative advanced or metastatic breast cancer in women with prior disease progression after endocrine therapy. This XRAYS reviews a newly published study in the New England Journal of Medicine that looks at overall survival in the original PALOMA-3 study. (1/23/19)

Relevance: High

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Strength of Science: High

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Research Timeline: Post Approval

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Study: Can population-based DNA sequencing find more people at risk for hereditary cancers?

Most relevant for: Women over age 30

It is well documented that many BRCA mutation carriers are missed using current family history-based screening approaches. As a result, experts are beginning to call for population-based BRCA genetic testing—an organized effort to screen all women like we do for breast and cervical cancer.  A recent study looked at whether a population-based genetic testing approach would better identify mutation carriers compared with current practice. (11/17/18)

Relevance: High

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Quality of Writing: High

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Article: The importance of racial diversity in clinical trials

Most relevant for: People who are a member of a racial or ethnic minority group

This article by journalists Caroline Chen and Riley Wong looks at racial disparities between participation in clinical trials and the population of people with cancer. (11/6/18)

Relevance: Medium-Low

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Strength of Science: Medium

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Research Timeline: Human Research

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Study: A new method for determining whether genetic variants in BRCA1 increase cancer risk

Most relevant for: People who have a Variant of Uncertain Significance in a gene associated with cancer risk.

Ever since BRCA1 was discovered, researchers have been trying to understand which of the thousands of possible DNA changes in this gene increase cancer risk and which are harmless changes.  A new study in Nature reports how a cutting-edge technology called “genome editing” may be used to classify changes—known as variants of uncertain significance-in BRCA1 as harmful or harmless. Once validated, this same technology may be used to classify variants in other genes. (9/29/18)

Relevance: Medium-High

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Strength of Science: Medium-High

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Research Timeline: Human Research

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Study: Gardening improves health outcomes for breast cancer patients

Most relevant for: People diagnosed with breast cancer who would benefit from increased activity and from eating more vegetables

Research has shown that adopting a healthier lifestyle may improve overall health and outcomes for cancer survivors. This study looked at a 1-year home-based gardening intervention to increase activity and wellbeing among breast cancer survivors. (08/31/18)

Relevance: Medium-High

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Strength of Science: Medium-High

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Research Timeline: Post Approval

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Study: Study identifies genes associated with risk of triple-negative breast cancer

Most relevant for: People diagnosed with triple-negative breast cancer

Panel testing can identify women who are at increased risk for breast cancer.  However, those at risk for triple-negative breast cancer cannot easily be identified because other than BRCA1, genes that increase the risk for triple-negative breast cancer are unknown.  A new study uses panel testing to identify which genes increase the risk for triple-negative breast cancer. (8/23/18)

Relevance: Medium-High

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Strength of Science: Medium

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Research Timeline: Human Research

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Study: Immunotherapy may lead to long-term remission of metastatic breast cancer

Most relevant for: People with advanced cancers

Metastatic breast cancer is often difficult to treat. In a new approach, called adoptive cell therapy (ACT), a patient’s own T-cells (a type of cancer-fighting immune cells) are collected, multiplied in a lab, and then returned to the patient. The goal is to enhance the patient’s immune system with many more T-cells that recognize and attack metastasized tumor cells. This study reports on a single patient whose metastatic breast cancer is still in remission (no evidence of disease) after more than 22 months following ACT. (8/16/18)

Relevance: High

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Quality of Writing: High

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Article: High health insurance deductibles can interfere with breast cancer treatment decisions

Most relevant for: People diagnosed with breast cancer

A New York Times article published on May 4, 2018 examines the impact of high insurance deductibles on breast cancer treatment. (7/12/18)

Relevance: Medium

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Strength of Science: Medium

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Research Timeline: Human Research

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Study: Evaluation of some direct-to-consumer genetic testing reveals inaccuracies and misinterpretations

Most relevant for: People who are considering or have had direct-to-consumer testing

A clinical genetic testing laboratory examined results from direct-to-consumer genetic testing ordered directly by patients. They found many instances of false positives—reported mutations that were not actually present—and in some cases, reports of variants that "increased risk," but were actually benign. This study emphasized the importance of involving genetics experts in the interpretation of genetic test results. (6/28/18)

Relevance: Medium-High

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Strength of Science: Medium-High

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Research Timeline: Human Research

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Study: Mutations in Lynch syndrome genes MSH6 and PMS2 may be associated with breast cancer

Most relevant for: Women with an MSH6 or PMS2 mutation

Some women with mutations in MSH6 and PMS2, two Lynch syndrome genes, may have a modest (2 to 3-fold) increased risk for breast cancer. (6/14/18 updated 09/25/19)

Relevance: Medium

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Strength of Science: Medium-High

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Research Timeline: Human Research

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Study: Metastasis is affected by wound healing and inflammation in study on mice

Most relevant for: Cancer patients who will be, or have recently undergone surgery

This study in mice looked at how wound healing after surgery affects metastasis. Researchers found that wound healing caused changes in the mouse immune system that allowed some cancer cells to grow, but that treatment with a non-steroidal anti-inflammatory drug (NSAID) reduced inflammation and frequency of metastases. While this research is promising, it remains to be seen if similar effects occur in humans. (5/17/18)

Relevance: Medium

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Research Timeline: Post Approval

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Guideline: FDA approves at-home test kits for inherited cancer: how useful are they?

Most relevant for: People who are considering or have had direct-to-consumer testing through 23andMe

Interest in personalized genetic testing is growing. Genetic testing about health conditions typically requires a prescription from a health care provider. Until recently, the direct-to-consumer (DTC) testing market has focused on ancestry and discovery of unknown branches of family trees. A laboratory called 23andMe that provides direct-to-consumer genetic testing has been given FDA approval to report results for 3 mutations found in the BRCA1 and BRCA2 genes. The FDA statement provides details about this approval and cautions consumers about the limitations of the 23andMe test. (03/19/18)

Relevance: Low

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Strength of Science: Medium

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Research Timeline: Animal Studies

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Study: Is asparagus linked to breast cancer metastasis?

Most relevant for: People diagnosed with breast cancer

A new study published in the journal Nature shows that asparagine, a protein building block that takes its name from asparagus, promotes the spread of breast cancer in mice. The study by cancer experts from Britain, Canada and the U.S. investigated whether limiting the levels of asparagine in mice could reduce tumor metastasis. (3/2/18)

Relevance: Medium-High

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Quality of Writing: Medium-High

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Article: Coping with the financial burden of breast cancer

Most relevant for: People diagnosed with breast cancer

U.S. News & World Report recently talked to three breast cancer survivors, including two young women, about how they handled out-of-pocket costs and other medical expenses after their cancer diagnosis. (Posted 1/4/18)

Relevance: Medium-High

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Strength of Science: Medium-High

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Research Timeline: Post Approval

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Study: Genetic counseling by phone or face-to-face

Most relevant for: People referred to a genetic counselor or those considering genetic testing

Results presented at the 2017 American Psychological Association’s annual meeting showed genetic counseling by telephone is as “safe and effective” in long-term psychological and social outcomes compared to traditional in-person counseling for women at risk for hereditary breast and ovarian cancer. This presentation is an update on research published in 2014. (11/29/17)

Relevance: High

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Quality of Writing: High

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Article: FDA busts myths of preventing and treating cancer by eating apricot kernels, herbs, and other ingredients

Most relevant for: People diagnosed with or concerned about their risk for cancer

Maggie Fox (NBC News) writes about a new FDA report that warns of 14 "fraudulent” cancer products claiming to either cure or treat cancer (1). The companies that sell these products claim that many of them also prevent cancer, but are they safe or effective? (6/26/17)

Relevance: High

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Strength of Science: Medium-High

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Research Timeline: Post Approval

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Study: Does scalp cooling help prevent hair loss after chemotherapy?

Most relevant for: Patient undergoing chemotherapy

Hair loss is one of the most recognized and distressing side effects of some chemotherapies. Two studies looked at the use of scalp cooling therapy to help reduce hair loss after chemotherapy for early-stage breast cancer. (5/15/17) 

Update: Based on data from clinical trials, the FDA approved Dignicap scalp cooling device for treatment in patients diagnosed with solid tumors who are receiving chemotherapy. 

Relevance: Medium-High

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Strength of Science: Medium

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Study: Does eating soy affect the risk of death in breast cancer survivors?

Most relevant for:

Is eating soy safe for people who have had breast cancer? This topic has been controversial among health care providers, patients, and survivors for many years because research has yielded mixed results. Some studies suggest people who have been diagnosed with breast cancer should eat more soy products, while other studies recommend they eat less or avoid it altogether. Which should it be? Adding to this research is a new study that asked breast cancer survivors about their soy consumption before and after diagnosis. (4/27/17)

Relevance: Medium-Low

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Strength of Science: Medium-High

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Research Timeline: Animal Studies

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Article: Does metastasis happen earlier than previously thought?

Most relevant for:

Sharon Begley discusses an unconventional new idea about how cancer cells spread (a process known as metastasis) in her recent piece for the website STAT. She states that, “cancer cells spread way earlier than thought, seeding metastases that cause most deaths.” (3/28/17)

Relevance: Medium-High

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Strength of Science: Medium-High

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Study: Friends and family may help breast cancer survival

Most relevant for: People diagnosed with breast cancer

Does having a large social network help breast cancer survivors have better outcomes? Research from the current study found that socially isolated breast cancer survivors had an increased risk of recurrence and breast cancer-specific mortality. (3/16/17)

Relevance: Medium-High

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Strength of Science: Medium

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Research Timeline: Human Research

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Study: Research suggests exercise is safe for breast cancer patients at risk for lymphedema

Most relevant for: People with, or at high risk for lymphedema after breast cancer

Patients and health care providers are often concerned about how exercise affects lymphedema (swelling in the arm or hand) in breast cancer survivors or other women who have had lymph node biopsy at the time of mastectomy. Research on this topic has been mixed. A new study suggests that exercise after breast cancer treatment does not lead to lymphedema or worsen existing lymphedema. However, because this study was small, more work needs to be done to understand the relationship between exercise and lymphedema in cancer survivors. (2/22/17)

Relevance: Medium-Low

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Strength of Science: Medium-High

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Research Timeline: Lab Research

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Study: Hot chili pepper component slows growth and kills laboratory-grown breast cancer cells

Most relevant for: This research is not relevant to people yet

Finding new treatments that target triple-negative breast cancer is an area of great interest. An early step in developing these treatments is learning more about the biology of tumor in the laboratory. This study looked at how capsaicin, the spicy component of chili peppers, might work with a protein found in many cancers, including triple-negative breast cancer, to stop cancer cell growth. This is the first step in a long process towards developing new treatments for triple-negative breast cancer. (2/14/17)

Relevance: Medium-High

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Quality of Writing: Medium

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Personal Story: Men get breast cancer too

Most relevant for: Men diagnosed with breast cancer

Cathy Free's piece for People, “Men Have Breasts Too: New York Man Who Survived Stage 2 Breast Cancer Spreads Message,” tells the stories of two men whose experiences with breast cancer inspired them to speak openly about breast cancer awareness for men. (11/29/16)

Relevance: Medium-High

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Strength of Science: Medium

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Study: Cancer treatment costs can vary widely

Most relevant for: People diagnosed with breast cancer

Healthcare providers cannot give their breast cancer patients information on chemotherapy treatment costs because not enough is known about the exact costs. New research finds that costs vary not only between different cancer treatments, but also between similar treatments, such as all treatments that target HER2+ breast cancer. (11/22/16)

Relevance: Medium-High

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Quality of Writing: High

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Personal Story: CBS News brings attention to the issues facing young metastatic breast cancer patients

Most relevant for: Women diagnosed with metastatic breast cancer

Beth Caldwell is a former civil rights lawyer, a mother of two, and a wife who was diagnosed with stage 4 metastatic breast cancer when she 37. Mary Brophy Marcus covered Beth’s story in her piece, “The hardest part” of breast cancer under 40, for CBS News. (11/8/16)

Relevance: Medium

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Strength of Science: Medium

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Study: Breast cancer mortality among Hispanic women in the United States varies by country of origin

Most relevant for:

"Hispanic" is a broad ethnic category that includes people from numerous countries. When discussing breast cancer statistics, Mexicans, Cubans, Puerto Ricans and people whose families originated in Central and South America are typically grouped into one Hispanic category. A new study looked at whether the country of origin affected breast cancer prevalence and mortality rates in Hispanic women in the U.S. (10/25/16)

Relevance: High

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Quality of Writing: High

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Article: Huffington Post article brings attention to metastatic breast cancer

Most relevant for: People diagnosed with metastatic breast cancer

Barbara Jacoby's Huffington Post piece, "How do breast cancer and metastatic breast cancer differ?" emphasizes the need for more treatment options for patients with advanced breast cancer.

Relevance: Medium-High

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Strength of Science: Medium

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Research Timeline: Post Approval

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Study: Rare mutations in PALB2, CHEK2, and ATM: how much do they increase cancer risk?

Most relevant for: People who tested positive for one of the rare variants in CHEK2, ATM or PALB2 that are covered in this study

As multi-gene panel tests become more common, people are discovering they have mutations in genes that are not understood as well as BRCA. This can make it difficult to give patients accurate assessments of their cancer risk. For example, mutations in PALB2, CHEK2, and ATM are rare, but some specific changes in these genes are even less common. The goal of this international collaboration was to better understand the cancer risks of some very rare PALB2, CHEK2, and ATM mutations. The findings are relevant only to the specific mutations covered in this paper and do not apply to all people with mutations in PALB2, CHEK2, or ATM. (9/27/16)

Relevance: Medium

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Quality of Writing: High

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Article: A cancer patient’s tumor is genetically profiled—how does that info help treatment?

Most relevant for: People diagnosed with advanced cancer

Jessica Wapner's Scientific American article explores the difficulties of making the vast amount of information acquired from tumor gene tests useful to patients and physicians. (9/20/16). Update: THIS INFORMATION HAS BEEN UPDATED. In late 2017, the FDA approved two separate tumor profiling tests to help guide treatment choices. The FoundationOne CDx (F1CDx) genomic test has been approved to test for 15 different targeted therapies used to treat five types of cancer, including ovarian, colorectal, lung, breast and melanoma. The FDA also approved the MSK-IMPACT and developed for use by Memorial Sloan Kettering Cancer Center (MSKCC) to scan tumor samples for 468 different cancer-associated mutations or alterations.

Relevance: Medium-High

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Strength of Science: Medium-High

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Research Timeline: Human Research

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Study: Can acupressure be used to treat cancer-related fatigue?

Most relevant for: Breast cancer survivors and people in treatment who are experiencing fatigue

Breast cancer survivors commonly report experiencing considerable fatigue, which can lead to sleep problems and poor quality of life. Yet, there are no good therapies for these patients. This research study looks at whether self-administered acupressure can help breast cancer survivors with their fatigue. (8/9/16)

Relevance: Medium-High

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Strength of Science: Medium-High

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Study: Financial burden affects quality of life of cancer survivors

Most relevant for: People diagnosed with cancer

Cancer-related financial burden can keep survivors from getting the care that they need, yet how this burden affects mental and physical health is still unknown. A study found that almost one-third of cancer survivors report having financial burden; those most likely to be affected were under age 65, female, members of racial or ethnic minority groups, and people who lack access to adequate insurance. (5/17/16)

Relevance: Medium-High

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Strength of Science: Medium-High

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Study: Factors that affect the ability to work in people with metastatic cancer

Most relevant for: People living with metastatic cancer

Some patients who live with metastatic cancer either want or need to continue working while coping with symptoms of their disease and treatment. A recent study that looked at over 600 people with metastatic breast, prostate, colon, or lung cancer found that about one-third of them continue working full or part time. People most likely to continue working were those undergoing hormonal treatment and those with less severe symptoms or side effects from treatment. (4/12/16)

Relevance: Medium

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Strength of Science: Medium-High

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Research Timeline: Post Approval

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Study: What are the genetics underlying 12 different cancer types?

Most relevant for: People diagnosed with cancer

As gene sequencing has become more affordable, researchers and health care providers are now looking for mutations in many genes beyond BRCA1, BRCA2 and others that are associated with known hereditary cancer syndromes. By sequencing thousands of genes rather than just one or two, researchers can better understand which inherited mutations affect cancer risk. In this study, researchers sequenced thousands of genes in patients with one of 12 cancers, including breast, and catalogued which gene mutations are most commonly found in each cancer. (03/01/16)

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