Breast Cancer

ASCO--A phase III multinational trial has shown docetaxel (Taxotere) to be more effective than doxorubicin (Adriamycin) as single-agent treatment of patients with metastatic breast cancer who have failed an alkylating-containing regimen.

ASCO--A brief, intensive preoperative chemotherapeutic regimen failed to improve breast cancer survival over conventional adjuvant chemotherapy in a 1,500-patient randomized trial, Dr. Eleftherios Mamounas said for the National Surgical Adjuvant Breast Project (NSABP). However, preoperative treatment often resulted in complete clinical remission prior to surgery.

ASCO--Anthracycline-based chemotherapy should join tamoxifen (Nolvadex) as standard therapy for postmenopausal breast cancer patients who have positive lymph nodes and are estrogen-receptor positive.

A new study strengthens the evidence that ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) reduce the risk of breast cancer in some women.

It is unusual to find an entire book dedicated to one therapeutic agent because a balanced, comprehensive analysis generally requires a somewhat broader perspective, particularly if it is targeted not only to the physicians treating a particular disease

Since the emergence of paclitaxel (Taxol) in 1983, clinical developmentof the taxoids has progressed at a rapid pace, with the introduction ofdocetaxel (Taxotere) into clinical trials in 1990, and international phaseII studies in 1992. Although these two taxoids are related, increasingclinical experience indicates that paclitaxel and docetaxel should notbe considered interchangeable.

SAN DIEGO--Reports from the American Association for Cancer Research annual meeting have moved researchers closer to answering the question of whether DDT and its metabolites act as a risk factor for breast cancer by mimicking endogenous estrogen.

CHICAGO--Because adjuvant systemic chemotherapy has led to real and meaningful improvement in long-term disease-free and overall survival of women with invasive breast cancer, "perhaps the primacy of surgery is not sacrosanct," said David Hyams, MD, executive medical officer of the NSABP, Allegheny General Hospital, Pittsburgh.

ASCO--Doxorubicin (Adriamy-cin) plus paclitaxel (Taxol) used in combination resulted in better overall response rates and longer time-to-treatment failure than either agent used alone as first-line treatment of metastatic breast cancer, George W. Sledge, Jr., MD, of Indiana University School of Medicine, reported at the ASCO meeting.

NEW ORLEANS--Adoption of a low-fat, high-carbohydrate diet reduces the area of mammographic densities in the breast, a strong risk factor for breast cancer, Norman F. Boyd, MD, of the Ontario Cancer Institute, Toronto, reported at the American Society for Preventive Oncology meeting.

CHICAGO--Despite an overall trend toward breast conservation, many breast cancer authorities believe that ductal carcinoma in situ (DCIS) too often is treated by mastectomy, and that axillary dissection and irradiation frequently are performed unnecessarily.

ASCO--Women with estrogen receptor (ER)-positive breast cancer who have no evidence of lymph node involvement should be added to the list of breast cancer patients who can benefit from adjuvant chemotherapy, Bernard Fisher, MD, said at the plenary session of the 33rd Annual ASCO Meeting.

The Society of Surgical Oncology surgical practice guidelines focus on the signs and symptoms of primary cancer, timely evaluation of the symptomatic patient, appropriate preoperative evaluation for extent of disease, and role of the surgeon in

A pilot phase II study examined the feasibility of 75 mg/m² of docetaxel (Taxotere) in combination with 50 mg/m²of doxorubicin and 500 mg/m² of cyclophosphamide (Cytoxan, Neosar) in the first-line treatment of metastatic breast cancer. This study was designed to evaluate the efficacy and toxicity of the docetaxel/doxorubicin/cyclophosphamide combination both alone and as induction before high-dose chemotherapy, supplemented by autologous peripheral blood stem-cell transplantation.

Protocol B-27, conducted by the National Surgical Adjuvant Breast and Bowel Project (NSABP), is a phase III, randomized trial designed to evaluate whether sequencing docetaxel (Taxotere) to neoadjuvant doxorubicin/cyclophosphamide (Cytoxan, Neosar) prolongs disease-free and overall survival in patients with operable breast cancer.

This was a phase I dose-finding and pharmacokinetic study of vinorelbine (Navelbine) and docetaxel (Taxotere) as first-line chemotherapy for metastatic breast cancer. Vinorelbine dose, 20 or 22.5 mg/m², on days 1 and 5, was followed on day 1 by docetaxel every 21 days, in doses increasing from 60 to 100 mg/m².

Development of the taxoids has progressedrapidly in the 1990s. In vitro studies have demonstrated that docetaxel(Taxotere) has a longer residence time and higher accumulation within tumorcells than paclitaxel (Taxol), possibly accounting for its greater cytotoxicity.

This trial was designed to determine the recommended maximum tolerated dose (MTD), toxicity, pharmacokinetics, and efficacy of docetaxel (Taxotere) and cyclophosphamide (Cytoxan, Neosar) for phase II studies. Both drugs were administered to 39 patients with advanced solid tumors, 26 of whom had breast cancer.

This phase I dose-finding study examined the effects of the combination of doxorubicin and docetaxel (Taxotere) in 42 women with metastatic breast cancer. The combination was studied at six different dosing levels. The maximum tolerated doses were defined as doxorubicin, 50 mg/m², and docetaxel, 85 mg/m², with sepsis as the dose-limiting toxicity.

With the proper nursing care, do women recovering from breast cancer surgery do better at home than in the hospital? To answer this question, researchers at Michigan State University's colleges of Nursing and Human Medicine are undertaking

CHICAGO--When a breast cancer patient is to receive both adjuvant chemotherapy and radiotherapy after surgery, the question remains as to which should be given first.

DENVER--The AMC Cancer Research Center, through its Center of Excellence in Health Communications, has developed The Personal Guide to Breast Cancer, a multimedia CD-ROM guide to breast cancer prevention, detection, treatment, and resources, designed to be understood by the average layperson.

SAN DIEGO--A retinoid with specificity for the RXR receptor has shown potential as a virtually nontoxic chemo-preventive agent for breast cancer.

Carcinoma of the cervix is one of the most common malignancies in women, accounting for 15,700 new cases and 4,900 deaths in the United States each year. Worldwide, cervical cancer is second only to breast cancer as the most common

NASHVILLE, Tenn--Inhibition of transforming growth factor-beta (TGF-beta) may enhance the activity of tamoxifen (Nolvadex) in breast cancer and restore tamoxifen sensitivity to resistant cells, according to results of laboratory experiments at the Vanderbilt Cancer Center and Georgetown's Lombardi Cancer Center.

SAN DIEGO--In a groundbreaking study, researchers at the Mayo Clinic have documented that prophylactic mastecto-mies may dramatically reduce the risk of breast cancer in high-risk women. The risk reduction was measured as high as 91%, lead investigator Lynn Hartmann, MD, said at the 88th annual meeting of the American Association for Cancer Research (AACR).

At a symposium sponsored by Schering-Oncology/Biotech, 16 researchers involved in studies of the investigational antiestrogen agent toremifene (Fareston) discussed its potential role in the treatment of patients with advanced breast cancer and as adjuvant therapy, as well as other breast cancer issues. Previous articles in this series appeared in January 1997 , February 1997 , and March 1997

BERN, Switzerland--A study of 1,619 breast cancer patients has identified a population subset with a very low incidence of lymph node metastases in whom axillary lymph node dissection might be omitted, Andreas Barth, MD, told Oncology News International.

MIAMI BEACH, Fla--Radiation therapy may not be necessary after the removal of ductal carcinoma in situ (DCIS), Gordon F. Schwartz, MD, said at the 14th International Breast Cancer Conference. In his experience, only 3% of DCIS patients who received breast-conserving surgery alone later experienced invasive breast cancer.

PARIS--The treatment of breast cancer in pregnant women remains controversial, not least because pregnant and lactating women are traditionally excluded from clinical trials. Now a prospective long-term study from M.D. Anderson Cancer Center suggests that multimo-dality treatment does not pose any untoward threat to either mother or child.