Breast Cancer

PHILADELPHIA--At Long Beach Community Medical Center, the addition, in 1993, of a new radiation therapy facility and a new cancer center spurred the development of clinical pathways (or practice guidelines) for radiation therapy and breast cancer.

WASHINGTON--A General Accounting Office (GAO) report has found that more insurers are now covering autologous bone marrow transplants (ABMT) for patients with breast cancer even though the treatment is expensive and the benefits are not proven.

COLLEGEVILLE, Penn--Rhône-Poulenc Rorer Inc.'s Taxotere (docetaxel) is now available for treatment of patients with locally advanced or metastatic breast cancer that has progressed during anthracycline-based therapy or relapsed during anthracycline-based adjuvant therapy.

GAITHERSBURG, Md--The FDA's Oncologic Drugs Advisory Committee (ODAC) voted unanimously to recommend approval of Ciba-Geigy Corp.'s Aredia (pamidronate disodium for injection) for the treatment of osteolytic bone metastases in breast cancer patients undergoing either chemotherapy or hormonal therapy.

DALLAS--In the last 5 years, radiologists have become the specialists most often sued over breast cancer diagnoses, said Cathy R. Bowerman, JD, MPH, of the Southfield, Michigan, firm of Siemion, Huckabay, Bodary, Padilla, Morganti, & Bowerman.

DALLAS--RODEO breast MRI proved significantly more accurate than mammography in determining the extent of lobular carcinoma and in characterizing the morphology of the disease, Steven E. Harms, MD, said at the American College of Radiology breast cancer symposium.

It is ironic that the issue of aggressive local therapy for breast cancer has re-emerged as a controversial issue in the early 1990s, almost 100 years after Halsted proposed this theory in the early 1890s [1]. Since that time, both survival and quality of life seemed to have improved for patients with breast cancer, due to more sophisticated and effective treatments. Nonetheless, as Drs. Pierce and Lichter point out in their article, the precise balance between the benefits and risks of aggressive local therapy still remains to be defined.

WASHINGTON--The breast cancer death rate in American women has declined steadily in the 1990s, suggesting that improved breast cancer management from early detection to treatment is having a beneficial effect, the National Cancer Institute reports.

Results of a phase III multicenter European study reported in a recent issue of the European Journal of Cancer demonstrate that anastrozole (Arimidex), a new aromatase inhibitor, in doses of 1 and 10 mg orally once daily, is an effective treatment for

WASHINGTON--University of Pennsylvania researchers have obtained the first "conclusive" evidence linking mutations in the recently cloned BRCA2 breast cancer gene to ovarian cancer, a discovery they say indicates that inheritance plays a significantly greater role in the disease than previously thought.

WASHINGTON--A study of European women suffering from breast cancer has raised the intriguing possibility that the ratio of omega-3 to omega-6 polyunsaturated fatty acids (PUFA) may provide a way to predict an increased risk of the malignancy.

ASCO--Immediate high-dose consolidation chemotherapy supported by transplant significantly improved disease-free survival in metastatic breast cancer patients who were in complete remission after induction therapy.

BALTIMORE--Intensive, laboratory-based follow-up programs for patients treated for early stage breast cancer do not enhance survival or reduce morbidity, said John H. Fetting, MD, at a symposium sponsored by Johns Hopkins Oncology Center, where he is co-director of the Breast Service.

An expert panel of seven cancer researchers and a representative of the National Alliance of Breast Cancer Organizations (NABCO) came together at the San Antonio Breast Cancer Symposium for a roundtable discussion of the use of tamoxifen (Nolvadex), sponsored by PRR, Inc., publisher of Oncology News International, Primary Care & Cancer, and the journal ONCOLOGY.

WASHINGTON--Interim results from an on-going Italian chemopreven-tion trial of a synthetic retinoid show a "borderline significant" protective effect against contralateral breast cancer and, to a lesser degree, against ovarian cancer, but only in premenopausal women.

COLLEGEVILLE, Penn--Rhône-Poulenc Rorer Inc. has received clearance from the US Food and Drug Administration to market Taxotere (docetaxel) for Injection Concentrate.

The National Cancer Institute (NCI) recently announced that the breast cancer death rate in American women continued to decline through 1993.

DALLAS--Estradiol scans, currently being used in research for the diagnosis of early breast cancer (see illustration on page 1), have in some cases identified breast cancer 2 years prior to diagnosis by conventional means, such as mam-mography, physical examination, and ultrasound, David F. Preston, MD, said in an interview with Oncology News International.

The incidence of breast cancer has risen steadily over the past several decades. Breast cancer is second only to lung cancer as a cause of cancer deaths among women; 46,000 women died of breast cancer in the United States alone in 1995. Despite efforts to improve the survival of women with metastatic breast cancer with currently available chemotherapeutic agents, results remain disappointing. The primary use of such agents continues to be for palliation, not cure.

Several new agents undergoing clinical development appear to be effective and tolerable in the management of metastatic breast cancer. In recent years, a number of new and exciting combinations have been described, with an efficacy similar or, in some cases, apparently superior to that of standard chemotherapeutic regimens, such as FAC and CMF. The next several years will witness a large number of comparative clinical trials, the major purpose of which will be to establish the role of these new drugs and combinations in the management of metastatic breast cancer. Almost simultaneously, similar strategies will be pursued for adjuvant therapy for primary breast cancer, with the goal of improving the curative efficacy of current regimens. These prospects are exciting; however, enthusiasm must be tempered with the knowledge that long-term toxicity is always a distinct possibility. Therefore, the development of new combinations, especially in the setting of adjuvant chemotherapy, should follow a systematic, conservative strategy. [ONCOLOGY 10(Suppl):30-36, 1996]

Over the past 5 years, many new cytotoxic agents with activity against metastatic cancer have been discovered, and several are currently undergoing clinical trials. Whether their marked degree of activity represents a real

The definition of refractory advanced breast cancer remains elusive. Because of different definitions of objective response, frequent lack of precision in defining the number of prior chemotherapies, and differing interpretations

The treatment of refractory metastatic breast cancer is complex and challenging. Practicing oncologists must choose from an array of therapuetic options. Palliation remains the primary goal of treatment, and the risks and

NEW YORK--Cell-adhesion molecules (proteins on the cell surface that interlock with those of other cells) appear to play an important role in checking tumor metastasis, says Dr. Rachel Hazan, a biochemist at Memorial Sloan-Kettering Cancer Center.

Areview of major clinical trials strongly supports the value of mammography screening for women in their 40s. The review showed a 24% decrease in deaths from breast cancer among women who underwent screening mammograms compared to

ImClone Systems has initiated an additional phase Ib/IIa clinical trial of C225, the company's epidermal growth factor (EGF)-receptor antagonist. The dose-escalation study will evaluate C225 in conjunction with the chemotherapeutic agent paclitaxel

PARIS--Paclitaxel (Taxol), the flagship of the new taxanes, has been hailed as a pharmacologic breakthrough, but its ideal use in the treatment of breast cancer is still a matter of debate. Speaking at the Sixth International Congress on Anti-Cancer Treatment (ICACT), National Cancer Institute oncologist Joyce O'Shaughnessy attempted to answer the most compelling unanswered questions about paclitaxel use.

TORONTO--TRUQUANT BR RIA, Biomira Diagnostics Inc.'s radio-immunassay, has been cleared for marketing for the early detection of recurrent breast cancer in patients previously treated for stage II or III cancer. According to the company, it is the first breast tumor marker test to receive expedited review by the FDA and is the first such test to be approved. The test is expected to cost approximately $50, the company said.

Aspecifically designed monoclonal antibody has been shown to reduce tumors in patients with late-stage breast cancer, according to a new study by scientists at Memorial Sloan-Kettering Cancer Center.

This report was prepared by a special committee of the Royal College of Radiologists. It provides a British perspective on how to manage this potential complication of breast irradiation.