(This is part of the Health Rounds newsletter, where we present the latest medical studies on Tuesdays and Thursdays.)
Written by Nancy Lapid
April 1 (Reuters) – Advanced genetic testing could help erase a huge disparity in breast cancer survival rates between white and black patients, new research has found.
Currently, Black women in the US have a 40% higher death rate from breast cancer than white women, despite the 5% rate of this disease.
Using genetic analysis of early breast cancer samples collected from more than a thousand women, researchers found that black women had high-risk tumors that are often missed by conventional clinical biomarkers, such as estrogen receptor levels. That leads to less attention, which may result in negative consequences.
When tumors were diagnosed with commercially available genetic tools and patients received appropriate care, black women had the same “excellent” results three years later as white women, according to a npj Breast Cancer study report.
Tumor genetic profiling was performed using MammaPrint and BluePrint tests from Agendia, which identify early stage tumors as Ultra Low, Low, High 1, or High 2 risk for spreading throughout the body in the next 10 years. The results help determine whether chemotherapy is needed.
The three-year recurrence-free survival was driven by genomic makeup, not race, the researchers found.
Black women with low-risk tumors based on MammaPrint and BluePrint had “good 10-year outcomes, with an overall survival rate of 97.7%, a similar outcome to white women,” the researchers reported.
Patients with high-risk tumors were five to 10 times more likely to have distant metastases than those with low-risk tumors, regardless of race.
About half of the patients who appeared to be at low risk developed aggressive tumors based on genomic profiling, the researchers also found.
The data suggest that “tumor genomic testing for all patients may help guide treatment decisions to reduce racial disparities among Black women with breast cancer,” said study co-author Dr. Andrea Menicucci from Agendia.
HEART ATTACK SURVIVORS MAY NOT NEED BETA-BLOCKERS
Stable, relatively low-risk heart attack survivors can stop taking common drugs from a class known as beta-blockers after a year, rather than continuing for life, according to a clinical trial from South Korea.
Researchers enrolled 2,540 patients who had recovered from heart disease and were given beta-blockers such as metoprolol, sold under the brand names Lopressor and atenolol.
Those who stopped taking the medication after at least 12 months had the same chance of death, more heart attacks, or hospitalization for heartburn as those who continued to take it, researchers reported at the American College of Cardiology scientific meeting in New Orleans.
Over a 3.5-year period, one or more serious adverse events occurred in 7.2% of those who discontinued beta-blockers and 9% of those who continued them, according to study data published in The New England Journal of Medicine.
Beta-blockers, which lower heart rate and blood pressure, have long been the mainstay of treatment to reduce the risk of subsequent heart attacks.
However, many studies confirming their benefits were carried out decades ago, before modern methods and drugs were available.
“In practice, for stable patients of several years suffering from heart disease, the cessation can be taken by making shared decisions and by monitoring blood pressure and heart rate,” study leader Dr. Joo-Yong Hahn of Samsung Medical Center in Seoul said in a statement.
In patients with beta-blocker-related side effects – fatigue, dizziness, bradycardia, hypotension – the issue of smoking cessation is even stronger.
Because all patients were enrolled in South Korea and very few women participated, the results may not be generalizable, the researchers noted.
A COMMON WAY TO PREVENT LONG-TERM CONTINUITY OF COVID
The widely used, inexpensive antidepressant fluvoxamine significantly improved fatigue and quality of life among adults with chronic COVID in a clinical trial, researchers report.
The trial enrolled 399 adults in Brazil with fatigue lasting at least 90 days after confirmed SARS-CoV-2 infection. Participants were assigned to receive fluvoxamine, the common diabetes drug metformin, or a placebo for 60 days.
Fluvoxamine reduced fatigue more than placebo, with a 99% chance that the drug was more effective than placebo, according to a report published in the Annals of Internal Medicine.
“Fluvoxamine has shown consistent and meaningful benefits, and because it is now widely used and well understood, it has clear potential for clinical use,” study leader Edward ‌Mills of McMaster University in Hamilton, Ontario said in a statement.
Metformin has been shown to reduce the risk of prolonged COVID when taken during an infection, but it did not help the people in this study with fatigue symptoms of prolonged COVID.
“This trial gives doctors their first strong evidence for a drug that helps reduce chronic fatigue in COVID,” study co-author Jamie Forrest of the University of British Columbia said in a statement.
Professor Christiaan Vinkers of the Medical Center of the University of Amsterdam, who was not involved in the study, said the results should be interpreted with caution because patients give specific reports about their symptoms and the study focused on fatigue and did not evaluate other long-term aspects of COVID.
“The results are promising, but replication is essential, preferably in broader groups of patients and results that reflect the full range of long-term COVID,” said Vinkers.
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(Reporting by Nancy Lapid; Editing by Bill Berkrot)
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