Breast Cancer

Sequential dosing may improve the effectiveness of adjuvant chemotherapy regimens in node-positive breast cancer, by limiting overlapping toxicity while maximizing dose-intensity, Clifford A. Hudis, MD, said at the Chemotherapy Foundation's 13th annual symposium. At Memorial Sloan-Kettering Cancer Center, where Dr. Hudis is assistant attending physician in the Breast Cancer Medicine Service, researchers are testing a sequential dosing regimen that combines doxorubicin, paclitaxel (Taxol), and cyclophosphamide, supported by granulocyte-colony stimulating factor (G-CSF, Neupogen).

The anticancer benefits of nonsteroidal anti-inflammatory drugs (NSAIDs), seen in studies of colon cancer risk, may extend to human breast cancer as well.

PARIS--Although properly applied high-dose chemotherapy can produce massive cytoreduction in breast cancer, it may not be adequate to cure the disease. "The problem has never been the achievement of remissions with high-dose therapy; the problem is making them stick," Larry Norton, MD, of Memorial Sloan-Kettering Cancer Center, said at the Sixth International Congress on Anti-Cancer Treatment.

VILLEJUIF, France--Salvage therapy with docetaxel (Taxotere) produced responses in more than a quarter of heavily pretreated, anthracycline-resistant breast cancer patients, said Jean-Louis Misset, MD, an oncologist at Paul Brousse Hospital, Villejuif.

A new DNA-based sequencing technique-Sequence Based Diagnosis (SBD)-that determines p53 gene status in primary breast cancers, yields better prognostic information than standard immunohistochemistry, according to a study in the February 20, 1996, issue of the Journal of the National Cancer Institute. The findings may have important implications for some of the over 180,000 US women diagnosed annually with breast cancer.

Breast-conserving surgery without radiation therapy is not an effective treatment for early-stage breast cancer, a Harvard Medical School study concludes.

SAN FRANCISCO--Use of estrogen supplements may lower breast cancer mortality, an American Cancer Society study has shown. The study, which was discussed at the ACS's science writers meeting, followed 400,000 women who provided data about their cancer risk factors. After 9 years, breast cancer mortality was 16% lower in those women who used estrogen, suggesting that their tumors were less aggressive.

Although most studies of the relationship between oral contraceptives (OCs) and breast cancer have focused on a possible causative role for OCs, new data suggest that breast cancer patients with a history of OC use may actually fare better than women who have never taken the pill.

African-American breast cancer patients survive as long as their Caucasian counterparts, a new study with up to a 40-year follow-up shows. The study, conducted at the University of Chicago, also found that African-American women do not have more aggressive cancer.

It is widely accepted that the causation of cancer is the result of environmental exposures (including endogenous hormone exposure) and genetic susceptibility. Ultimately, to prevent breast cancer, we must understand both the environmental and genetic components.

It is perhaps not surprising that the increased incidence of a disease that has a major impact on mortality in young women (even though the absolute risk of death from breast cancer in this age group is low) should create so much interest. Yet, despite decades of research, it is by no means clear that everyone would agree with King and Schottenfeld that the appropriate approach to breast cancer prevention is one that "focuses on the physiologic effects of the sex steroid hormones and their potential interactions with family history." However, this tantalizing statement appearing at the end of the abstract of their article fortunately is elaborated upon at the end of the article itself. This elaboration refers specifically to physical activity, energy consumption, obesity, pregnancy history and exogenous estrogens and their potential interactions with family history, with which many will agree.

Drs. King and Schottenfeld have provided an interesting review of the literature in their attempts to relate changes in breast cancer incidence over time to secular changes in postulated risk factors.

Breast cancer incidence rates in the United States rose by 24% between 1973 and 1991. Mortality during this period, however, remained stable. Both the 5-year relative survival rate and the rates of in situ and stage I

SAN ANTONIO--Screening mam-mography significantly improves breast cancer survival in women ages 40 to 49, compared with other methods of cancer detection, a Minnesota study suggests.

BETHESDA, Md--Concerned that a New England Journal of Medicine article reporting no link between fat intake and breast cancer might deter women from joining the diet-cancer segment of the NIH-sponsored Women's Health Initiative (WHI), its top leaders took an unusual step.

PARIS--The luteinizing hormone-releasing hormone (LHRH) agonist goserelin (Zoladex) proved as effective as surgical ovariectomy in premenopausal women with estrogen and/or progestogen receptor-positive metastatic breast cancer, a randomized multicenter study has shown.

Data presented at the 18th Annual San Antonio Breast Cancer Symposium in Boulder, Colorado, shows that moderate-dose DaunoXome, NeXstar Pharmaceuticals' liposomal formulation of daunorubicin, is well-tolerated and has promising efficacy in treating advanced breast cancer. Moreover, the limited toxicity observed in this trial, particularly the absence of cardiotoxicity, suggests that DaunoXome may be useful in ameliorating the side effects that accompany high-dose anthracycline-based chemotherapy for metastatic breast cancer. The data, generated in a phase II study funded by NeXstar, were presented by P.S. Hupperets, MD, of the Akademisch Ziekenhuis, in Maastricht, The Netherlands.

PITTSBURGH--Victor Vogel, MD, MHS, will lead a newly established joint breast cancer program of the University of Pittsburgh Cancer Institute and Magee-Womens Hospital. He will also join the University of Pittsburgh as professor of medicine and epidemiology.

An expert panel of seven cancer researchers and a representative of the National Alliance of Breast Cancer Organizations (NABCO) came together at the San Antonio Breast Cancer Symposium for a roundtable discussion of the use of tamoxifen (Nolvadex), sponsored by PRR, Inc., publisher of Oncology News International and the journal ONCOLOGY.

In clinical trials, screening mammography has been shown to reduce mortality from breast cancer by about 25% to 30% among women aged 50 years and older after only 5 to 6 years from the initiation of screening. Among women 40 to 49 years old, the evidence supporting the efficacy of screening mammography is less convincing.

his article discusses the costs and benefits of mammographic screening in the workplace. The cost of mammography itself and of diagnostic work-up are two of the largest costs involved.

SAN ANTONIO--Three studies reported at the San Antonio Breast Cancer Symposium show no apparent adverse effects of hormone replacement therapy (HRT) on breast cancer and, in fact, suggest that breast cancers in patients with a history of HRT may have a more favorable prognosis in terms of histologic grade and estrogen-receptor (ER) levels.

COLLEGEVILLE, Penn--Rhône-Poulenc Rorer Inc. and the National Surgical Adjuvant Breast and Bowel Project (NSABP) have announced the initiation of a new clinical trial (B-27) utilizing docetaxel (Taxotere) in women with operable breast cancer.

BETHESDA, Md--The American Medical Writers Association is seeking applications for the 1996 Rose Kushner Awards for Writing Achievement in the Field of Breast Cancer.

SAN ANTONIO--First-line chemotherapy with docetaxel (Taxotere) produced response rates as high as 68% in a series of studies involving patients with advanced, metastatic breast cancer.