Work absence after breast cancer diagnosis

August 15, 2015

Compared to matched health control women, women with breast cancer who remained free of the disease for at least 3 years after diagnosis were much more likely than healthy women to be absent from work for 4 weeks or more (85% vs. 18%). However, by the third year work absence patterns were similar. The authors also report work absence and its patterns for women who underwent chemotherapy, and describe factors that modulate absence patterns (such as being in a stable relationship and being self-employed).

Some of these absences exceeded the 15-week federal employment insurance available during periods of illness. The shorter patterns of work absence among the self-employed and those who were single may represent expressions of the financial burden of this common illness.

See "Work absence after breast cancer diagnosis : a population-based study -- E. Maunsell et al" PDF

cma/cmaj

In this model, pieces of the very large HER-2/Neu molecule are broken up into little fragments and bound to the MHC Class 1 molecule within the antigen-presenting cell. This is what the killer T cell "sees" at the cell surface. These killer T cells, which are being produced in the spleen, where Listeria usually colonizes, seek out and destroy the tumor. This system ensures an increase in the production of killer T cells that can recognize the HER-2/Neu pieces on the surface of the tumor cell. In addition, the Penn team helped the immune system along by fusing the tumor antigen to a bacterial protein that seems to activate antigen-presenting cells. They have found that by doing this the immune system now recognizes regions of the HER-2/neu molecule that are not immunogenic when presented by other vaccine approaches.

Paterson first hit on the idea of using Listeria as a cancer vaccine vector over ten years ago. "It took a while to dissect what elements of an immune response were best able to cause the rejection of established tumors," she says. "But in the last couple of years it has paid off and we are very excited to see the technology finally being tested in cancer patients. The dream of the cancer immunotherapist is to provide an alternative and more humane way of controlling metastatic disease than current chemotherapies."

The Listeria vector is currently being prepared for a clinical trial targeting a tumor antigen associated with cervical cancer by Advaxis Inc., a cancer vaccine biotech company that has licensed Penn patents on the use of Listeria monocytogenes as a vaccine vector. Paterson is the scientific founder of Advaxis and Chair of the Scientific Advisory Board. The successful demonstration that the Listeria vector technology can also be used with the HER-2/neu molecule paves the way for applying this promising cancer vaccine approach to breast cancer.

This research was funded by the Department of Defense and the National Cancer Institute. Co-authors are Reshma Singh and Mary E. Dominiecki, both from Penn, as well as Elizabeth M. Jaffee from the Johns Hopkins University School of Medicine. This release and related images can also be found at: www.uphs.upenn/news.

med.upenn/