Breast Cancer Central

Targeted Therapies Hit Breast Cancer Hard

FRIDAY, May 13 (HealthDay News) -- Evidence is mounting that so-called targeted therapies, including Herceptin, work well against breast cancer.

In two North American trials of Herceptin, women with aggressive breast cancer who took the drug after surgery and chemotherapy had a 52 percent reduction in the risk of a recurrence, compared with women who did not take the drug. Because of the positive results, the trials were halted early.

Researchers at the American Society of Clinical Oncology annual meeting in Orlando, Fla., delivered more good news: A third trial of Herceptin showed a 46 percent reduction in risk among women who took the drug simultaneously with chemotherapy.

Link: Targeted Therapies Hit Breast Cancer Hard

Bevacizumab + chemotherapy improves progression-free survival for patients with advanced breast cancer: study

Preliminary results from a large, randomized clinical trial for patients with previously untreated recurrent or metastatic breast cancer show that those patients who received bevacizumab (Avastin) in combination with standard chemotherapy had a longer time period before their cancer progressed than patients who received the same chemotherapy without bevacizumab.

Preliminary results suggest that patients in the study who received bevacizumab in combination with standard chemotherapy consisting of single-agent paclitaxel had a delay in worsening of their cancer by four months, on average, compared to patients treated with paclitaxel chemotherapy alone. This difference is statistically significant.

Link: Bevacizumab   chemotherapy improves progression-free survival for patients with advanced breast cancer: study

Reduced heart risk with modern breast cancer radiation therapy

The researchers found the there was 13.1% mortality due to heart disease in those patients who had left sided cancer as compared to a 10.2% mortality of the right-sided cancer patients. This data was found in diagnosis of cases between 1973 to 1979. However, between 1980 to 1984 and 1985 to 1989, a significant drop in the mortality was seen. This was attributed to advanced radiation deliver systems, which targeted only the cancer cells and spared healthy ones.

Dr. Sharon Giordano, lead researcher says that improvements in radiation techniques and delivery have greatly impacted radiation-associated cardiac mortality. She adds that, "This study should reassure patients that radiation has become safer and there is little, if any, risk of future ischemic heart disease due to having received radiation."

Link: Reduced heart risk with modern breast cancer radiation therapy.

MRI Better Than Current Standard of Practice In Assessing Neoadjuvant Chemotherapy in Breast Cancer Patients

More breast cancer patients with large palpable tumors are now undergoing chemotherapy before surgery in an effort to reduce the size of their tumor, and MRI is the best way to predict if the chemotherapy is working, preliminary results of a study show. If the chemotherapy is successful, then the woman may be able to undergo breast-conservation surgery rather than a mastectomy.

Currently, it is standard practice for the physician to do a breast examination to non-invasively assess whether the chemotherapy was effective, said Eren Yeh, MD, an instructor of radiology at Massachusetts General Hospital in Boston, and the lead author of the study. “Before we began the study, we weren't sure if breast tumors would enhance with the MR contrast agent gadolinium and therefore be visible after chemotherapy. Our study found that MRI is not perfect, but it's better than what's been used as the gold standard in the past,” she said.

Link: MRI Better Than Current Standard of Practice In Assessing Neoadjuvant Chemotherapy in Breast Cancer Patients.

Higher dose chemotherapy improves survival from breast cancer -- Mayor 330 (7490): 500 -- BMJ

Higher dose chemotherapy reduces overall risk of relapse after breast cancer by 22% compared with less aggressive regimens. Similar benefits were seen in older and younger women, results from a meta-analysis show (JAMA 2005;293:1073-81).

The study retrospectively analysed data from four randomised clinical trials of treatments for lymph node positive breast cancer in 1975-99. Each trial compared more aggressive with less aggressive chemotherapy regimens, including a treatment arm using drug doses or schedules that were regarded as being high.

A total of 6487 women with lymph node positive breast cancer were included, with 542 (8%) aged 65 years or older and 159 (2%) aged 70 years or older.

Results showed that the degree of chemotherapy was significantly related to disease-free survival and overall survival (P<0.001). Patients treated with more intensive chemotherapy were 22% less likely to relapse than patients who received less chemotherapy (hazard ratio 0.78, 95% confidence interval 0.72 to 0.85).

Link: Higher dose chemotherapy improves survival from breast cancer -- Mayor 330 (7490): 500 -- BMJ.

Circulating Tumor Cells Prove To Be Key Predictors of Survival in Newly Diagnosed Metastatic Breast Cancer Patients

Homogenous test group reinforces value of information gleaned through simple blood test -

Veridex LLC, a Johnson & Johnson company, today announced that a study published in the Journal of Clinical Oncology (March 1, 2005) found that the presence of circulating tumor cells (CTCs) in the blood of patients newly diagnosed with metastatic breast cancer is highly predictive of progression-free, overall survival, and is associated with significant prognostic information. Further, the results indicate that the company's CellSearch™ System, which was used to identify and enumerate CTCs - cancer cells that detach from solid tumors and enter the bloodstream - may one day allow for design of tailored treatments earlier than ever before possible.

Link: Circulating Tumor Cells Prove To Be Key Predictors of Survival in Newly Diagnosed Metastatic Breast Cancer Patients.

ABRAXANE(TM) Achieved Statistically Significant Prolongation in Survival by 2.5 Months in Patients Who Received ABRAXANE(TM) as Second-Line or Greater Therapy Compared to Taxol(R), Reducing Risk of Death by 29%

SCHAUMBURG, Ill., Feb. 25 /PRNewswire-FirstCall/ -- American
Pharmaceutical Partners, Inc. (Nasdaq: APPX) today announced that the pivotal
Phase III clinical study of ABRAXANE(TM) for Injectable Suspension (paclitaxel
protein-bound particles for injectable suspension) (albumin-bound) in patients
with metastatic breast cancer demonstrated a statistically significant
improvement in survival in second-line patients.  The data were presented at
the 22nd Annual Miami Breast Cancer Conference in Miami, FL, by Edith Perez,
M.D., Professor of Medicine, Mayo Clinic College of Medicine, Chair Breast
Committee, North Central Cancer Treatment Group.  Dr. Perez's presentation of
new anti-tubulin agents included for the first time an initial analysis of
survival data from the prospectively randomized trial of 460 patients with
metastatic breast cancer.

The study population included patients who were previously untreated and
those who were previously treated (second-line or greater-line therapy) for
metastatic breast cancer.  In the overall patient population, median survival
for those patients receiving ABRAXANE was 10 weeks longer (65.0 weeks v.
55.7 weeks) than for patients receiving Taxol but this difference did not
reach statistical significance.  However there was a significant prolongation
in survival (p=0.016) in patients receiving ABRAXANE in the second-line or
greater setting as compared to those receiving Taxol (56.4 weeks vs.
46.7 weeks).  In this group, there was a 29% reduction in the risk of death
(i.e., hazard ratio of 0.71) for patients who received ABRAXANE compared to
those who received Taxol.

ABRAXANE consists only of albumin-bound paclitaxel nanoparticles and no
toxic solvents.  As previously reported, in the Phase III clinical study,
ABRAXANE demonstrated a superior response rate with an almost doubling of the
reconciled target lesion response rate when compared with the solvent-based
Taxol(R).  Because it contains no toxic solvents, this next-generation taxane
product enables the administration of 50% more chemotherapy with a
well-tolerated safety profile, requires no premedication to prevent
hypersensitivity reactions and can be given over 30 minutes using standard
IV tubing.  The Phase III study was designed to compare ABRAXANE(TM) at a dose
of 260 mg/m2 given as a 30-minute infusion without premedication to paclitaxel
injection (Taxol(R)) at 175 mg/m2 given as a 3-hour infusion with standard
steroid and antihistamine premedication.

ABRAXANE(TM) was launched on February 7, 2005 by Abraxis Oncology, the
proprietary division of APP after having received FDA approval in January.
ABRAXANE is indicated for the treatment of breast cancer after failure of
combination chemotherapy for metastatic disease or relapse within 6 months of
adjuvant chemotherapy.  Prior therapy should have included an anthracycline
unless clinically contraindicated.

Breast Cancer Treatment Reduces Risk of Ischemic Heart Disease

Women with breast cancer treated with the anti-estrogen drug tamoxifen are at significantly less risk of having a heart attack or symptoms of heart stress such as angina, according to a new study. The study, published in the March 15, 2005 issue of CANCER (http://www.interscience.wiley.com/cancer-newsroom), a peer-reviewed journal of the American Cancer Society, finds the benefit becomes pronounced within two years of therapy and is maintained throughout its use.

Tamoxifen has been shown to reduce the risk of breast cancer recurrence by as much as 50 percent. In addition, increasing evidence indirectly supports its protective effects on the heart. Studies have shown women taking tamoxifen show reductions in markers of cardiac disease, such as bad cholesterol and homocysteine. However, there is little direct evidence of tamoxifen's heart protective benefits by way of reduced morbidity or mortality.

To evaluate its hypothesized cardioprotective affects, Brian D. Bradbury, D.Sc., M.A. and a team of investigators from Boston University's Schools of Medicine and Public Health reviewed the records of 3030 breast cancer patients treated with tamoxifen and 4233 patients with other cancers not treated with tamoxifen.

Women treated with tamoxifen were less likely to develop symptomatic heart disease than those who did not receive tamoxifen. On further analysis current use of tamoxifen was associated with significantly reduced risk of heart disease. Moreover, the reduced heart disease effects were observed in women who had completed less than two years of therapy and continued throughout the duration of the five years of recommended therapy.

The authors conclude, "These data are consistent with the proposition that treatment with tamoxifen for women with breast cancer may additionally lower a woman's risk of developing ischemic heart disease."

Optimata's Virtual Clones to Predict Therapy Outcome for Breast Cancer; Adriamycin, Docetaxel, Paclitaxel, Vinorelbine and Tamoxifen in Validation Study

Optimata Ltd. and the Soroka University Medical Center announced today the launch of a validation study for the treatment of breast cancer using Optimata's revolutionary Virtual Cancer Patient technology. The technology creates an in silico 'clone' for each patient and predicts how the patient will respond to leading cancer drugs such as Adriamycin, Docetaxel, Paclitaxel, Vinorelbine and Tamoxifen.

The goal is to improve the efficacy of breast cancer treatments and to avoid the harsh and toxic treatments that patients often undergo at present, when the schedule of chemotherapy is determined by trial-and-error.

"Breast cancer patients currently are all treated according to the same chemotherapy protocols, yet only between 15-65 percent of the patients respond to the chemotherapy. There is a need to find an empirical way of individualizing the therapy for each patient," said Prof. Samuel Ariad, Head of Soroka's Institute of Oncology and Chief Investigator in the study.

Link: Optimata's Virtual Clones to Predict Therapy Outcome for Breast Cancer; Adriamycin, Docetaxel, Paclitaxel, Vinorelbine and Tamoxifen in Validation Study.

Anxiety, Emotional Suppression, and Psychological Distress Before and After Breast Cancer Diagnosis

The authors examined the influence of anxiety and emotional suppression on psychological distress in 21 patients with breast cancer and 72 patients with benign breast tumor. The patients with breast cancer who suppressed emotion and had chronically high levels of anxiety felt higher levels of emotional distress both before and after the diagnosis. Such patients need psychological interventions, including encouragement to express and communicate their emotions, immediately after disclosure of the diagnosis to help maintain psychological adjustment in the face of the disease. (Psychosomatics 2005; 46:19-24)

Patients who receive a diagnosis of breast cancer generally are greatly shocked and upset. However, individual breast cancer patients differ in the extent to which they report feeling psychological distress. Watson and Greer1 proposed that emotional suppression or control is a factor in these individual differences. They viewed emotional suppression as a component of the type C behavior pattern, which was originally defined by Temoshok,2 as involving a "chronically blocked expression of needs and feelings" and the belief that it is "useless to express one's needs." Eysenck3 and Gross4 suggested that the type C pattern is associated with the onset and prognosis of cancer.

Link: Anxiety, Emotional Suppression, and Psychological Distress Before and After Breast Cancer Diagnosis.