N. Lynn Henry, MD, PhD | Authors

CYP2D6 Testing for Breast Cancer Patients: Is There More to the Story?

December 16, 2009

The promise of pharmacogenetics is personalization of therapy for individuals through refinement of the risk/benefit profile of pharmaceuticals based on inherited gene mutations. Classic examples of the impact of pharmacogenetics in clinical practice include variants in dihydropyrimidine dehydrogenase and treatment with fluorouracil.

Complexities of Adjuvant Endocrine Therapy in Young Premenopausal Women

May 14, 2009

Younger women with breast cancer present important management challenges due in part to differences in both tumor biology and individual patient factors. In his article, Peppercorn provides a comprehensive overview of these issues with a particular focus on questions surrounding systemic therapy options.

Aromatase Inhibitor–Associated Musculoskeletal Symptoms: Etiology and Strategies for Management

November 15, 2008

In the United States, approximately 180,000 women are diagnosed with breast cancer annually.

Use of Gene-Expression Profiling to Recommend Adjuvant Chemotherapy for Breast Cancer

October 01, 2007

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.

Management of Patients With Muscle-Invasive and Metastatic Bladder Cancer

September 01, 2005

Bladder cancer is the fifth most common cancer diagnosed in theUnited States. Prognosis for this disease is dependent on both tumorstage and grade. Radical cystectomy has been the standard treatmentfor muscle-invasive local disease; however, combined-modality approacheswith the use of chemotherapy are gaining momentum withdata suggesting survival improvement. Patients with metastatic diseasehave poor long-term survival rates despite systemic multiagent chemotherapy.A variety of agents, including newer cytotoxic drugs and biologicallytargeted agents, are under investigation to determine the mosteffective regimen. The special needs of specific patient populations,such as the elderly, those with a suboptimal performance status, andpatients with medical comorbidities have gained more attention.Progress in the treatment of this disease is dependent on supportingongoing and future clinical trials.