Breast Cancer

ORLANDO-Adding capecitabine (Xeloda) to docetaxel (Taxotere) (XT) significantly improves response rates, time to progression, and overall survival, compared with docetaxel alone in patients with metastatic breast cancer, according to results of a phase III study of the combination.

BARCELONA, Spain-In patients with metastatic breast cancer, weekly dosing with docetaxel (Taxotere) appears to provide benefits equal to those of every-3-week dosing, according to results of a multicenter, randomized, European phase II

JACKSONVILLE, Florida-An encouraging study reported at the 38th Annual Meeting of the American Society of Clinical Oncology (abstract 206) suggests that irinotecan (CPT-11, Camptosar) may prove valuable in advanced breast cancer.

MAYWOOD, Illinois-A novel fixed-dose schedule of uracil/tegafur (UFT) plus leucovorin (UFT/LV, also known as Orzel, investigational) achieved significant disease stabilization in advanced breast cancer, according to a phase II multicenter study reported at ASCO (abstract 240).

The addition of paclitaxel before surgery to primary systemic therapy with doxorubicin, followed by CMF

ORLANDO-Data from a massive pathologic reanalysis of breast cancer patients with apparently negative lymph nodes show that women with occult micrometastases have shorter disease-free survival and are more likely to die from breast cancer than are women whose nodes are negative on immunohistochemistry.

LOS ANGELES-Early data from a Breast Cancer International Research Group (BCIRG) study showed that docetaxel (Taxotere)-based combination therapy was significantly more effective than standard FAC (fluorouracil/doxorubicin

SAN FRANCISCO-Insulin resistance, as determined by C-peptide levels, appears to be linked to increased breast cancer risk, Celia Byrne, PhD, said at the 93rd Annual Meeting of the American Association for Cancer Research (abstract 1179). In a study of 1,226 women, those who developed breast cancer were more likely than controls to have elevated concentrations of C-peptide, considered an indication of insulin secretion.

HOUSTON-Weekly paclitaxel (Taxol) as part of a primary systemic chemotherapy regimen for operable breast cancer improves pathologic complete remission rates when compared with every 3-week paclitaxel therapy, according to results of a prospective phase III trial (ASCO abstract 135).

WASHINGTON-Uninsured Americans confront a greater likelihood of poorer health and premature death than those with private medical and hospital coverage, a committee of the National Academy of Sciences’ Institute of Medicine (IOM) has concluded.

MUNICH-Preoperative treatment of primary breast cancer with dose-dense sequential epirubicin (Ellence) and paclitaxel (Taxol) led to significant increases in breast-conserving therapy and in response rates compared to epirubicin and paclitaxel

ORLANDO-The National Initiative on Cancer Care Quality (NICCQ) has presented preliminary results from its ongoing survey of breast and colorectal cancer patients in five cities. The study, now in its second year, was prompted by a 1999 Institute of Medicine report that found serious gaps in the quality of care for many people.

NEW YORK-Weekly injections of epoetin alfa (Procrit) might protect breast cancer patients against anemia and improve their quality of life during adjuvant chemotherapy.

ATLANTA-When used to distinguish benign and malignant solid masses, high-resolution ultrasound may reduce the number of breast biopsies by as much as 28%, said Karen Hunt, MD, assistant professor of radiology, University of Michigan, Ann Arbor. Dr. Hunt, who is also senior staff radiologist at Henry Ford Hospital, presented the findings at the 102nd Annual Meeting of the American Roentgen Ray Society’s (abstract 138).

ORLANDO-ABI-007, an alternative, Cremophor-free intravenous paclitaxel (Taxol), developed using nanoparticle technology, provided pronounced single-agent efficacy in two multicenter phase II trials in metastatic breast cancer, according to data presented at the 38th Annual Meeting of the American Society of Clinical Oncology (abstract 209). In preclinical studies, ABI-007 resulted in significantly less toxicity than paclitaxel (abstract 462).

CHICAGO-Giving tamoxifen concurrently with adjuvant chemotherapy halves the benefit of the chemohormonal combination compared to giving tamoxifen after completion of chemotherapy in postmenopausal patients with node-positive, hormone-receptor positive breast cancer (ASCO abstract 143). These initial results from North American Breast Intergroup Trial 0100 (INT 0100, SWOG 8814), presented by Kathy S. Albain, MD, are expected to establish a new standard of care for treating breast cancer in postmenopausal women.

Two studies published recently in the Journal of Clinical Oncology showed promising response rates for docetaxel (Taxotere)-based therapy over existing therapies for several types of cancer

Over the past 2 decades, two major trends in the treatment of breast cancer-breast-conserving therapy and neoadjuvant (or preoperative) chemotherapy-have converged to stimulate interest in the use of neoadjuvant chemotherapy to facilitate breast conservation in women presenting with large tumors. After being established as the treatment of choice for locally advanced or inoperable breast cancer, theoretical considerations and the desire to extend breast-conserving therapy to more patients with large tumors have resulted in an increase in the use of neoadjuvant chemotherapy in operable patients. Drs. Green and Hortobagyi have provided us with a comprehensive review of the background and the current state of neoadjuvant chemotherapy for breast cancer.

It is nearly 30 years since the start of clinical trials of adjuvant chemotherapy in patients with operable breast cancer.[1] The rationale for using adjuvant chemotherapy at that time was that surgery and radiotherapy could only control local disease and cure patients who did not already have metastases. Chemotherapy could be used in patients with a poor prognosis to treat undetected micrometastatic disease and thereby reduce the risk of metastatic relapse and death from breast cancer.

Preoperative therapy delivers treatment at the earliest time in a tumor’s natural history. Is it beneficial or harmful? Should it be undertaken? The article by Drs. Green and Hortobagyi brings most aspects of neoadjuvant therapy under one umbrella and poses several key questions.

Adjuvant systemic chemotherapy has been shown to prolong survival in all subsets of patients with breast cancer. In addition, among patients with locally advanced breast cancer, neoadjuvant or preoperative chemotherapy has

In a recent issue of the Journal of the American College of Surgeons (194:648-656, 2002), a collective review led by Monica Morrow, MD, director of the Lynn Sage Comprehensive Breast Center at Northwestern Memorial Hospital in Chicago, presented recommendations on the use of ductal lavage in women at high risk for breast cancer. The article offers guidance on which women are most appropriate for ductal lavage and on how abnormal ductal lavage results should be managed.

Bedford Laboratories announced that it has received approval from the Food and Drug Administration to market pamidronate disodium for injection. The product will be the only liquid version available on the market, and is equivalent to the Novartis pamidronate disodium product (Aredia), a bone resorption inhibitor indicated for the treatment of hypercalcemia associated with malignancy, for Paget’s disease, and for osteolytic bone metastases of breast cancer and osteolytic lesions of multiple myeloma.

SAN FRANCISCO-Increased circulating levels of the protein leptin, which regulates body fat and fat mass, may be a risk factor for postmenopausal breast cancer, according to a presentation at the 93rd Annual Meeting of the American Association for Cancer Research (abstract 2503).

WASHINGTON-A survey of 110 Hispanic women at elevated risk for breast and/or ovarian cancer revealed a high degree of interest in genetic testing but a low level of knowledge about their own objective risk of getting these cancers, Martha P. Martinez, PsyD, said at the American Psychological Association Conference on Enhancing Outcomes in Women’s Health. Dr. Martinez is a voluntary instructor of medicine at the University of Miami School of Medicine.

TAMPA, Florida-Giving suboptimal care, in terms of chemotherapy regimens and dose intensities, is "compromising survival" of elderly patients, according to a report by Julie Meyer, MPH, of a study involving close to 24,000 patients with early stage breast cancer and non-Hodgkin’s lymphoma. Ms. Meyer is a nurse practitioner in the Senior Adult Oncology Program at H. Lee Moffitt Cancer Center and Research Institute in Tampa, Florida.

ASCO-Although aromatase inhibitors show promise for preventing recurrence following surgery in women with hormone-receptor-positive breast cancer, tamoxifen (Nolvadex) remains the standard of care, according to an evidence-based technology assessment of the aromatase inhibitors, sponsored by the American Society of Clinical Oncology. The ASCO expert panel found that the available data on aromatase inhibitors for this indication do not support routine use outside of clinical trials.

OMAHA-New research shows that some postchemotherapy fatigue in breast cancer patients is the result of disordered sleep and can be relieved by sleep intervention programs. At the 27th Annual Congress of the Oncology Nursing Society, Ann M. Berger, PhD, RN, AOCN, reported promising data from one such program that found that daily activity levels, fatigue, and quality of sleep all improved in cancer patients who went through a sleep intervention program. Dr. Berger is associate professor and advanced practice nurse at the University of Nebraska College of Nursing in Omaha.

BALTIMORE-New research indicates that exercise can play a significant role in combating fatigue related to cancer treatment and the accompanying loss of function fatigue brings, according to Victoria Mock, DNSc, RN. Dr. Mock is the American Cancer Society Professor of Oncology Nursing at Johns Hopkins School of Nursing and Director of Nursing Research Center at the Sidney Kimmel Comprehensive Center at Johns Hopkins in Baltimore.

The US Food and Drug Administration (FDA) has granted approval to AstraZeneca’s new breast cancer drug fulvestrant (Faslodex) for treatment of hormone-receptor-positive metastatic breast cancer in postmenopausal women with disease progression following antiestrogen therapy, with, for example, tamoxifen. Fulvestrant is an estrogen-receptor antagonist without known agonist effects. It is the only estrogen-receptor antagonist to be proven effective after tamoxifen failure.