Conference Roundup authors concluded, “As CIPN presents a diverse range of symptoms, better quantifying the subjective and objective measures of CIPN can help incorporate these tools in observational and intervention trials.”
© RUNPHOTO / GETTY IMAGES
MASSAGE FOR CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY Massage was found to alleviate chemotherapy-induced peripheral neuropathy (CIPN) in patients with breast cancer undergoing adjuvant paclitaxel, according to a study presented at the 2018 San Antonio Breast Cancer Symposium. CIPN can be a debilitating adverse effect of chemotherapy treatment, one whose alleviation using pharmacologic approaches may also have its own major side effects. The study authors turned to massage as a multidisciplinary approach to managing CIPN. The study was conducted at the Dr Abdurrahman Yurtaslan Ankara Training and Research Hospital in Turkey between July 2017 and June 2018, and included 37 patients with breast cancer who had no previous diagnosis of CIPN and who had received the first cycle of adjuvant paclitaxel. Eighteen patients were assigned to an intervention group that received 12 classical massage sessions on the days of chemotherapy treatment, encompassing a 20-minute foot massage and a 10-minute
The intervention group received both foot and hand massage sessions.
hand massage. Nineteen patients were assigned to a control group that received only routine care. Subjective patient assessment tools including the Self-Leeds Assessment of Neuropathic Symptoms and Sign (S-LANSS) were used to assess CIPN. Electromyography (EMG) was used as an objective CIPN measurement. The subjective S-LANSS scores of the patients who received the massage were significantly lower than the scores of the control group. Additionally, based on EMG, the muscle action potential of the ulnar nerve and posterior tibial nerve were significantly higher in the treatment group than the control group at week 12. Based on these results, incorporating classical massage into the overall care regimen of patients with breast cancer receiving adjuvant paclitaxel may prevent CIPN in these patients.
INCREASED BREAST CANCER RISK FOR AFRICAN AMERICAN VETERANS Women veterans may be at increased risk for breast cancer due to unique service-related exposures, such as burn pits, depleted uranium, and posttraumatic stress disorder (PTSD). However, results from a recent pilot study presented at the San Antonio Breast Cancer Symposium suggested the alternative possibility of an innate or genetic risk, particularly among female African American veterans, who have been traditionally underrepresented in breast cancer research. The study included a total of 99 female veterans, average age 54, recruited at Veteran Affairs Medical Centers in Bronx, New York, and Washington, DC, between 2015 and 2018. The majority of participants were African American (60%), with 13% Hispanic, 14% nonHispanic white, and 13% categorized as other.The study authors calculated 5-year and lifetime risks of developing invasive breast cancer using the Gail Breast Cancer Risk Assessment tool (BCRAT).
42 THE CLINICAL ADVISOR • JANUARY 2019 • www.ClinicalAdvisor.com
Among all patients, 35% were considered high risk with a 5-year BCRAT greater than 1.66%, 51% of whom were African American, 14% Hispanic, and 17% other. Overall, 22% of patients had prior breast biopsies and 57% had a family history of breast cancer. In comparison, among African American female veterans alone, 33% had prior breast biopsies and 94% had a family history of breast cancer. Encompassing all the study participants, 29% had PTSD, 31% of whom had a high risk of breast cancer. “To our knowledge, this is the only study with 60% African American women veterans. High participation rates among African Americans in this pilot study have uncovered the potential for further inquiry into this population,” wrote the authors.
METASTATIC vs EARLY STAGE HR+/HER2- BREAST CANCER MUTATIONS IDENTIFIED Use of whole exome sequencing of metastatic breast cancers has identified 11 driver gene alterations and 4 mutational processes enriched in hormone receptor-positive/ HER2-negative metastatic breast cancers. Fabrice Andre, of the Institut Gustave Roussy in France, who presented the results of the study at the 2018 San Antonio Breast Cancer Symposium, wrote that this additional information may help identify new candidate targets and stratify patients eligible for innovative therapies. The research included patients with metastatic breast cancer and available biopsy as part of several precision medicine trials (SAFIR01, SAFIR02, PERMED, MOSCATO, SHIVA). The researchers performed sequencing on 387 patients with HR-positive/HER2-negative breast cancer, 186 patients with triple-negative breast cancer, and 32 patients with HER2overexpressing breast cancers. Among these patients, 24 driver genes were significantly mutated. In the patients with HR-positive/HER2-negative