Aman U. Buzdar, MD | Authors

Lapatinib Plus Letrozole May Improve Efficacy

February 02, 2009

In metastatic breast cancer (MBC), lapatinib (Tykerb) + letrozole (Femara) delayed disease progression in HER2+, HR+ patients, according to initial results from a phase III trial (EGF30008) presented by Stephen Johnston, MD (abstract 46).

AIs vs Tamoxifen: Results of EBCTG Meta-Analyses

February 02, 2009

Based on 2 meta-analyses of nearly 20,000 HR+ early breast cancer patients, AIs are superior to tamoxifen in reducing recurrences, whether as initial monotherapy or given in a “switching” strategy (abstract 12).

More Notable Trials From SABCS 2008

February 02, 2009

Eidtmann H et al: The effect of zoledronic acid on aromatase inhibitor associated bone loss in postmenopausal women with early breast cancer receiving adjuvant letrozole: 36 months follow-up of ZO-FAST (abstract 44).

High-Dose Fulvestrant at Least as Good as Anastrozole in First-Line MBC

February 01, 2009

There is evidence that higher doses of fulvestrant (Faslodex) may have greater activity than the approved dose of 250 mg/mo. The FIRST trial (Fulvestrant First-Line Study) compared 500 mg vs anastrozole 1 mg/d in the first-line advanced disease setting, finding that a dose of 500 mg/mo achieved response rates and clinical benefit rates similar to those obtained with anastrozole 1 mg/d but gave a significantly longer time to progression (abstract 6126).

Optimizing the Use of Aromatase Inhibitors

February 01, 2009

EXPERT’S CORNER-Nearly three quarters of breast cancer patients have tumors that express estrogen receptors (ERs) or progesterone receptors (PRs); approximately half of these patients are postmenopausal. We look to endocrine therapy, therefore, to prevent recurrences and save lives in the majority of early breast cancer patients and to prolong survival in the advanced disease setting.

ABCSG Trial: Survival Benefit for Tamoxifen → Anastrozole

February 01, 2009

ABCSG Trial: Survival Benefit for Tamoxifen. Anastrozole Updated results from Austrian Breast and Colorectal Cancer Study Group Trial 8 confirmed a survival difference for the sequencing strategy of tamoxifen followed by anastrozole (Arimidex), compared to 5 years of tamoxifen (abstract 14). Preliminary results (median follow-up 55 mo) had previously revealed a 24% reduction in recurrence in favor of the sequencing strategy, although the difference was not statistically significant.

Trastuzumab: Further Considerations

December 01, 2006

One of the best examples of the "bench to bedside" process is the development of trastuzumab (Herceptin) for HER2-overexpressed breast tumors. From the identification of the neu oncogene in 1984[1] and its subsequent cloning,[2] to the development of a humanized monoclonal antibody targeting HER2 that improved outcome not only in the metastatic setting[3] but also in the adjuvant setting[4-7] has been a long yet fruitful journey.

Commentary (Dawood/Buzdar): Systemic Treatment of Breast Cancer

August 01, 2006

Over the past 20 years we have witnessed the emergence of a new generation of aromatase inhibitors as valuable antiestrogens in the management of both advanced and early-stage breast cancer. In addition, the list of cytotoxic chemotherapeutic agents useful in the control of breast cancer has grown considerably. The emergence of anthracyclines was a major chemotherapeutic step forward in the 1980s, and the taxanes have clearly been the agents with the greatest impact on breast cancer treatment over the past decade. The end of the past 2 decades has been characterized by a greater understanding of the molecular biology of breast cancer, rational drug design, and the development of agents that disrupt specific cellular targets and pathways. The development of better prognostic and predictive assays that employ a panel of genes involved in the malignant and metastatic phenotype promises to allow clinicians to better select patients who could forgo adjuvant chemotherapy. Finally, adjunctive and supportive therapy of breast cancer has evolved substantially over the past 20 years. This review will highlight some of the landmark accomplishments during this time, and offer a glimpse at where we might be 20 years from now.

Commentary (Buzdar): Optimizing Adjuvant Chemotherapy in Early-Stage Breast Cancer

December 01, 2005

This review of adjuvant chemotherapyby Perez and Muss isconcise and complete. For themost part, the authors present the datain a balanced way. The role of adjuvantchemotherapy has been establishedin breast cancer. Appropriateutilization of adjuvant chemotherapycan significantly reduce the risk ofdisease recurrence and improve survival.These benefits are associatedwith adjuvant chemotherapy regardlessof the age of the patient, nodalstatus, or hormonal status of cancer.

Commentary (Theriault/Buzdar): Pregnancy and Breast Cancer

May 01, 2005

Drs. Patridge and Schapira setout to review breast cancerand pregnancy, discuss treatmentoptions for breast cancer duringpregnancy, and summarize the availableevidence regarding safety of pregnancyafter breast cancer. This is asubstantial undertaking. They beginby reviewing the epidemiologic dataindicating an early increase in risk ofbreast cancer development after pregnancyand the likely long-term protectiveeffect of pregnancy on breastcancer risks. The subsequent focus oftheir review is on breast cancer duringpregnancy, a relatively rare occurrence.In a study from California,Smith et al indicated that the frequencyof breast cancer concurrent withpregnancy was 1.3 per 10,000 livesingleton births.[1] The authors notea frequently quoted figure of 1 in 3,000pregnancies.