Time codes (work-in-progress):
0:00 Intro
1:46 Hormonal therapy for breast cancer. History (Q)
6:02 oncology moves from advanced to early cancer
6:50 top advance in breast cancer therapy
7:17 prevention of 70% of breast cancers
7:49 prevention of 70% of breast cancers (Q)
8:17 prevention of 70% of breast cancers (A)
10:09 Tamoxifen
10:44 AIs
12:51 internet scares people away from AIs
13:23 Tamoxifen vs Anastrozole (Q)
13:38 AIs not for premenopausal women
14:21 Tamoxifen side effects (risk-benefit ratio)
16:55 LHRH agonists, Tamoxifen, AIs in breast cancer treatment (Q)
17:21 LHRH agonists, Tamoxifen, AIs in breast cancer treatment (A)
18:54 single use of tamoxifen or AIs going out of fashion
19:09 Tamoxifen, AI, LHRH use in combination (Q)
22:07 When breast cancer can be considered cured?
23:09 for RE+ breast cancer, you are never cured
24:14 breast cancer cells in bone marrow forever
25:02 Stress increases breast cancer recurrence
25:55 So how does the breast cancer cell living
in your bone marrow know that you had a bad day?
26:20 We know that women who lose weight have a
lower recurrence rate.
27:13 AIs for ten years?
28:03 What about the environmental hazards that
mimic estrogen horror hormones?
29:23 you need to understand that estrogens
are fundamentally considered to be promoters of cancer
30:30 And one of the models they used was the mouse ear skin.
31:32:10 estrogens promote genetic events that already
occur in women.
32:12:27 environmental estrogens.
33:29:23 If you have exposure to certain carcinogens,
you take away the estrogen promotion with
33:41:06 You’re raising an extremely important point. (HRT) Progestins and breast cancer
37:13:16 Progestins are horrible drugs for breast cancer
promotion.
37:28:11 What about opposing progestins?
38:13:11 Anti-progestins as a treatment for breast cancer have had some mild success.
38:34:18 The same could be said about drugs that target
the androgen receptor. We first showed,
39:08:12 Aromatase inhibitors can be of two types.
40:08:06 So there’s only one SERD around now. fulvestrant. Oral SERDs
41:45:29 And I suppose even consider SERDs in breast cancer prevention
trials.
41:49:09 But no one wants to do prevention clinical trials. It’s too expensive.
42:41:00 When breast cancer happens in premenopausal
women, production of estrogen by the ovaries or BSO
43:19:26 BSO vs LHRH in premenopausal
44:17:17 If you look at reasons why physicians
quit medicine or burnout.
44:51:26 Hormonal treatment for breast cancer is called
New adjuvant chemotherapy when chemotherapy
45:05:07 How to select neoadjuvant and adjuvant chemotherapy,
45:41:16 But in the neoadjuvant therapy has many advantages.
46:41:05 There’s something called pathologic complete
response.
47:49:24 Finally, in the United States, we amazingly
over-treat patients.
50:11:13 So I don’t think even the best way to do
neoadjuvant therapy for breast cancer
50:24:12 Immunotherapy is making huge advances
in several cancers. Q
50:43:11 Immune therapy is very attractive.
52:01:07 Breast Cancer doesn’t do that.