Joseph A. Sparano, MD

Dr. Sparano discusses the implications of TAILORx, the first trial to use Oncotype DX in clinical decision making.

TCGA’s efforts to dissect the genomic complexity found in breast cancer patients represents only the beginning of a journey toward better understanding of the intricacy of the events that lead to this disease. Additional efforts are required to provide tailored and effective therapeutic interventions.

Obesity rates in the United States have increased twofold in adults and threefold in children during the past 30 years.[1] Beyond its detrimental effects on cardiovascular health, obesity increases the risk of several cancers, including postmenopausal breast cancer,[2] and it is also associated with a higher risk of recurrence and death in those who develop breast cancer.[3]

Cancer Network speaks with Dr. Joseph Sparano, Professor of Medicine and Women’s Health at the Albert Einstein School of Medicine and Associate Chairman of the Department of Oncology at Montefiore Medical Center in New York, about the session he will chair at the ASCO Breast Symposium on September 8-10, in San Francisco.

Dr. Henderson provides a thoughtful perspective on an important question that many clinicians often consider: can we ditch anthracyclines in favor of other, more effective and/or less toxic chemotherapeutic agents?

One of the primary challenges in the treatment of patients with early-stage breast cancer is determining which patients will benefit from adjuvant chemotherapy. Traditionally, treatment decisions have been made based on a combination of tumor characteristics and patient and physician perspectives regarding risks and benefits. Recent technologic advances, including the development of gene-expression arrays, have led to the identification of molecular signatures that provide prognostic information in addition to the basic clinicopathologic features of individual tumors. While these new methods allow for more refined determination of prognosis for an individual patient, few data are available to support use of these new technologies in the clinic for treatment decision-making. At present, data from a single retrospective study are available to support the use of one assay, the 21-gene recurrence score, for decision-making regarding adjuvant chemotherapy. Large, multinational clinical trials are currently ongoing to evaluate the use of two of the multiparameter assays, although it will be many years before oncologists can apply the results of these trials in the clinic.