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Breast Cancer

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LOS ANGELES--A monoclonal antibody directed at the HER2 receptor greatly enhances the effect of chemotherapy for women whose breast cancer overexpresses the HER2 gene. This encouraging finding comes as experts are beginning to suspect that increasing dose intensity of conventional chemotherapy may have "gone about as far as it can go," said Dennis Slamon, MD, PhD, chief, Division of Hematology-Oncology, UCLA School of Medicine.

SAN FRANCISCO--Raloxifene (Evista), an estrogen-receptor modulator used to treat osteoporosis, also has a protective effect against breast cancer, according to a 2-year randomized study and an overview analysis reported at ASCO. These findings require some caution in interpretation, since they were mainly observed in women with osteoporosis, a population that has a lower breast cancer risk than the general population.

SAN FRANCISCO--Interim results of a major intergroup study of paclitaxel (Taxol) as adjuvant treatment of node-positive breast cancer "will change the standard of care for node-positive breast cancer patients," I. Craig Henderson, MD, of the University of California, San Francisco, said at ASCO.

NEW YORK--There is a soap opera scenario surrounding breast cancer survivors that goes something like this: "Breast cancer ruins the woman’s life. Her husband leaves her for another woman. She loses her job. She considers suicide but bravely goes on, knowing no man will ever want her. Looking in the mirror is her worst nightmare."

ORLANDO--Preoperative chemotherapy in breast cancer patients can leave a surgeon in the dark as to the specific amount of normal tissue to remove if the chemotherapy eliminates the tumor or renders it no longer palpable. A simple tattoo outlining the original tumor site can be a great aid in helping surgeons determine the type of surgery to be performed after the therapy.

LOS ANGELES--Taxane therapy lengthens survival in breast cancer patients, both in the metastatic and adjuvant settings, according to the results of two phase III trials presented at the 34th Annual Meeting of the American Society of Clinical Oncology (ASCO).

ASCO--Fewer than half of women with early-stage breast cancer are treated with breast-conserving lumpectomy, even though up to 75% are eligible. Almost one-quarter of those who have lumpectomy are not given radiotherapy to improve local control.

BUFFALO, NY--Studies have shown that only 15% to 20% of patients with metastatic breast cancer have a long-term disease-free survival following administration of high-dose chemotherapy with autologous bone marrow or stem cell support. "We have therefore decided to explore immunotherapy for this patient population," said Meir Wetzler, MD, of the Division of Medicine, Roswell Park Cancer Institute.

BALTIMORE--Adjuvant chemotherapy regimens for breast cancer are often reduced for patients over age 65 due to concerns about toxicity. These reductions may not be necessary in most cases. Elizabeth Claire Dees, MD, and her colleagues at the Johns Hopkins Oncology Center found that although older women had more neutropenia, this seldom resulted in clinical complications.

AVIANO, Italy--Elderly women with node-positive breast cancer are more vulnerable to chemotherapy-related toxicity. Physicians should be prepared to help older patients prevent or manage these problems and should not be too quick to reduce scheduled dosages, Diana Crivellari, MD, said at her ASCO poster presentation for the International Breast Cancer Study Group (IBCSG) Trial VII.

PITTSBURGH--Five years of prophylactic tamoxifen (Nolvadex) cut the risk of breast cancer almost in half in women at high risk for the disease. D. Lawrence Wickerham, MD, associate chairman of the National Surgical Adjuvant Breast and Bowel Project (NSABP), gave the first formal presentation of the results of the Breast Cancer Prevention Trial (BCPT) at the ASCO plenary session.

OXFORD, UK--The latest 5-year metaanalysis by the Early Breast Cancer Clinical Trialists’ Collaborative Group suggests that up to 20,000 additional lives could be saved each year worldwide if physicians prescribed adjuvant tamoxifen (Nolvadex) to all early breast cancer patients who could benefit, including premenopausal women.

ASCO--In two phase III trials, the anti-HER-2/neu monoclonal antibody (MoAB) Herceptin (trastuzumab, Genen-tech) showed significant activity both as a single agent and in combination with traditional cytotoxic chemotherapy in the treatment of HER-2/neu overexpressing metastatic breast cancer.

WASHINGTON--Feedback indicates that the National Cancer Institute did quite well in equipping counselors in advance to deal with questions posed by women about the ability of tamoxifen (Nolvadex) to prevent breast cancer, NCI director Richard D. Klausner, MD, told a Senate subcommittee.

ASCO--Postmenopausal women with osteoporosis who took raloxifene (Evista) for 2½ years to prevent fractures also had a significant 70% reduction in breast cancer risk, according to results of the Multiple Outcomes of Raloxifene Evaluation (MORE), reported at ASCO.