Breast Cancer

There are several million breast cancer survivors worldwide. In the United States, 180,000 women were diagnosed

SAN ANTONIO-The addition of docetaxel (Taxotere) to the combination of doxorubicin (Adriamycin) and cyclophosphamide (AC) is an effective and safe first-line therapy for women with metastatic breast cancer, Jean-Marc A.Nabholtz, MD, said at a poster session of the 21st Annual San Antonio Breast Cancer Symposium.

FORT LAUDERDALE, FL-In a first-of-its kind, the American Cancer Society (ACS) and the National Comprehensive Cancer Network (NCCN) have collaborated to produce “Breast Cancer Treatment Guidelines for Patients,” a detailed translation for the public of NCCN’s breast cancer practice guidelines. The NCCN is a coalition of 17 leading US cancer centers. Its practice guidelines have won acceptance among many oncologists as the “gold standard” of treatment.

HAMBURG, Germany-“Significant numbers of women with breast cancer have psychological distress that goes unidentified,” said David Payne, PhD, of the Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center.

SAN ANTONIO-A long-term Dutch study has provided additional evidence that the duration of tamoxifen (Nolvadex) therapy influences the degree of benefit for reducing breast cancer recurrence. However, the optimal duration of therapy remains an open question, Dr. Jan Vermorken, an oncologist at University Hospital, Antwerp, said at the San Antonio Breast Cancer Symposium.

HAMBURG, Germany-“We need to help partners of women with breast cancer realize their role in helping their wives, express their concerns, and gain more information,” Barry Bultz, PhD, said at the Fourth International Congress of Psycho-oncology.

SAN ANTONIO-Tamoxifen (Nolvadex) reduces the risk of contralateral breast cancer to a degree similar to its effect on primary breast cancer, according to an analysis of data from National Surgical Adjuvant Breast and Bowel Project (NSABP) clinical trials.

African-Americans are leading the fight against breast cancer in communities across the country. The Witness Project, the East-West Breast Express, and the Navigator Program are just a few examples of innovative programs funded by the Susan G. Komen Breast Cancer Foundation and their local affiliates that are improving the future for many African-American women.

SAN ANTONIO-Preliminary results from an ongoing clinical trial suggest that neoadjuvant chemotherapy of breast cancer with paclitaxel (Taxol) alone produces response rates comparable to those achieved with the three-drug FAC (fluorouracil, Adriamycin, cyclophosphamide) regimen.

There are several million breast cancer survivors worldwide. In the United States, 180,000 women were diagnosed with breast cancer in 1997, and approximately 97,000 of these women have an extremely low chance of a suffering a recurrence of their cancer. With an average age at diagnosis of 60 years and a 25-year expected duration of survival, the current number of breast cancer survivors in the United States may approach 2.5 million women. Since breast cancer is now being detected at an earlier stage than previously and since adjuvant chemotherapy may cause ovarian failure, an increasing number of women are becoming postmenopausal at a younger age after breast cancer treatment. This conference was convened in September 1997 to consider how menopausal breast cancer survivors should be treated at the present time and what future studies are needed to develop improved therapeutic strategies. A total of 47 breast cancer experts and 13 patient advocates participated. The proceedings of the conference are being published in six installments in successive issues of oncology. This third part focuses on the prevention of osteoporosis and the cardiovascular effects of estrogens and antiestrogens. [ONCOLOGY 13(3):397-432, 1999]

DALLAS-The Susan G. Komen Breast Cancer Foundation has launched the African American Women’s Initiative (AAWI), a landmark effort to create a national standard for African American breast health education.

LONDON-Combination chemotherapy with paclitaxel (Taxol) and mitoxantrone (Novantrone) represents a promising treatment strategy for poor-prognosis breast cancer patients, investigators in a small British study have concluded.

CHICAGO-The selective estrogen-receptor modulator (SERM) raloxifene (Evista) can dramatically reduce the incidence of breast cancer in healthy postmenopausal women, V. Craig Jordan, PhD, DSc, said at the San Antonio Breast Cancer Symposium. The agent is currently FDA approved for the treatment of osteoporosis in postmenopausal women.

MANCHESTER, UK-Prelim-inary experience with the pure antiestrogen faslodex (investigational) suggests the agent has activity in tamoxifen (Nolvadex)-resistant breast cancer while avoiding troublesome side effects such as hot flashes often observed with endocrine therapy, Dr. Anthony Howell said at the San Antonio Breast Cancer Symposium.

MANCHESTER, UK-An LHRH agonist (goserelin or buserelin) plus tamoxifen (Nolvadex) provides longer survival rates than an LHRH agonist alone in young metastatic breast cancer patients, according to data from the Combined Hormonal Agents Trialists (CHAT) group presented at the San Antonio Breast Cancer Symposium.

BOSTON-Various approaches to chemoradiation therapy for breast cancer offer advantages and disadvantages, and the challenge remains to choose the approach that best matches a patient’s characteristics, Harvard University radiation oncologist Abram Recht, MD, said at a minisymposium at the San Antonio Breast Cancer conference.

MONTREAL-Single-agent therapy with liposomal doxorubicin matched the response rate of conventional doxorubicin in patients with metastatic breast cancer but caused less toxicity, especially cardiotoxicity, Gerald Batist, MD, reported at the San Antonio Symposium.

ROME-Optimizing premedication and use of growth factors can improve the tolerability of docetaxel (Taxotere) while maintaining the agent’s activity in patients with anthracycline-resistant advanced breast cancer, according to results of a small Italian study presented at the San Antonio Breast Cancer Symposium.

PITTSBURGH-Two different National Surgical Adjuvant Breast and Bowel Project (NSABP) trials have provided evidence that doxorubicin “somehow changes the natural history” of breast cancer in patients whose tumors overexpress the HER-2 cancer gene, Soon Paik, MD, said at the San Antonio Breast Cancer Symposium.

AVENTURA, Florida-Herceptin (trastuzumab) has produced major objective responses in 20% to 25% of patients with previously untreated metastatic breast cancers that overexpressed the HER-2 breast cancer gene. The monoclonal antibody is approved for use as first-line therapy in combination with paclitaxel (Taxol) and as a single agent in second- and third-line therapy.

HAMBURG-Preliminary findings from a small German study presented at the San Antonio Symposium have provided what investigators describe as the first evidence that dose-intensive adjuvant chemotherapy improves disease-free survival in high-risk breast cancer patients.

NEW YORK-The field of adjuvant therapy for breast cancer has entered an era marked by great opportunities and challenges.

TAMPERE, Finland-Adjuvant treatment with the nonsteroidal estrogen inhibitor toremifene (Fareston) proved equivalent to tamoxifen (Nolvadex) for prevention of breast cancer recurrence but was associated with fewer embolic events, investigators in an ongoing Finnish trial reported at the San Antonio Breast Cancer Symposium.

BARCELONA-Clinical and scientific rationale increasingly supports the use of cytotoxic and bio-logic agents in combination to treat breast cancer, a Spanish oncologist asserted during a satellite meeting at the San Antonio Breast Cancer Symposium, sponsored by Bristol-Myers Squibb Oncology.

MANHASSET, NY-An open-label study of vinorelbine (Navelbine) followed by paclitaxel (Taxol) in patients with metastatic breast cancer has yielded an active dosing schedule for this regimen for use in phase II testing, Daniel R. Budman, MD, said at a poster session of the San Antonio Breast Cancer Symposium.

LOS ANGELES-Twice-weekly paclitaxel (Taxol) combined with radiation therapy constitutes a “promising primary management” strategy for locally advanced breast cancer, California oncologists reported at the San Antonio Breast Cancer Symposium.

NEW YORK-An overview of clinical trials of trastuzumab (Herceptin) has provided additional evidence that the agent has cardiotoxic effects, especially when used with anthracycline chemotherapy, according to data presented at the San Antonio Breast Cancer Symposium.

NEW YORK-Combination chemotherapy with doxorubicin and docetaxel (Taxotere) resulted in objective major responses in 32 of 51 patients with previously untreated metastatic breast cancer, setting the stage for a large-scale comparison of the combination against doxorubicin and cyclophosphamide.

CHICAGO-The first US multicenter cost analyses comparing autologous peripheral blood stem cell transplant (PBSCT) and autologous bone marrow transplant (BMT) in breast cancer and non-Hodgkin’s lymphoma (NHL) showed a cost advantage for stem cells in breast cancer, but not NHL. Tammy Stinson, project manager and analyst for Health Services Research, Northwestern University and VA Chicago Healthcare System, presented the results at the ASH meeting.

SAN ANTONIO-In a trial of first-line, single-agent therapy for metastatic breast cancers that overexpress the HER-2 breast cancer gene, Herceptin (trastuzu-mab) resulted in major objective responses in 20% to 25% of patients. The monoclonal antibody is approved for use as first-line therapy in combination with paclitaxel (Taxol) and as a single agent in second- and third-line therapy.