Oncology NEWS International Vol 12 No 7

MRI Detects Missed Breast Cancers in High-Risk Patients

July 01, 2003

ASCO—Three studies of MRI screening for women at high risk of breast cancer, presented at the 39th Annual meeting of the American Society of Clinical Oncology, show high sensitivity and the ability to detect cancers missed on mammography or ultrasound, but in two of the studies, the technique had lower specificity than mammography, resulting in unnecessary biopsies. The better specificity seen in the study from Germany may stem from the greater experience of the physicians involved in that study. The researchers agreed that MRI is not recommended for breast cancer screening in the general population, but should be considered in high-risk women as a complement to mammography, in an attempt to find breast cancers early in these women and reduce the need for prophylactic mastectomies. The German researchers, however, suggested that MRI could replace mammography screening in women at high risk of developing the disease. German Study

Adjuvant Chemotherapy Improves Lung Ca Survival

July 01, 2003

ASCO—Adjuvant cisplatin (Platinol)-based chemotherapy significantly improved survival in patients with completely resected non-small-cell lung cancer (NSCLC), Thierry Le Chevalier, MD, reported at the plenary session of the 39th Annual Meeting of the American Society of Clinical Oncology (abstract 6). Dr. Le Chevalier, professor of medicine, Gustav-Roussy Institute, Villejuif, France, concluded that adjuvant chemotherapy could be recommended and might prevent 7,000 deaths worldwide from NSCLC every year. The International Adjuvant Lung Cancer Trial (IALT), which included 1,867 patients treated in 148 centers in 33 countries across five continents, showed that chemotherapy conferred a 4.1% absolute benefit in overall survival and a 5.1% absolute benefit in disease-free survival after 5 years.

Combination Delays Breast Ca Progression

July 01, 2003

ASCO—Although evidence-based medicine tends to support the use of single-agent chemotherapy for metastatic breast cancer, trials are beginning to document a benefit from combination chemotherapy. One study, reported at the 39th Annual Meeting of the American Society of Clinical Oncology (abstract 25), showed a statistically significant improvement in time to disease progression and objective response when the combination of gemcitabine (Gem-zar) and paclitaxel was compared with paclitaxel alone. "Because of the favorable risk benefit profile reported in this clinical trial, gemcitabine/paclitaxel is a new treatment option for metastatic breast cancer patients who may benefit from combi-nation chemotherapy," said Joyce O’Shaughnessy, MD, codirector of the Breast Cancer Prevention Program, Baylor-Sammons Cancer Center, Dallas.

Primary Hypothyroidism Linked to Reduced Risk of Breast Ca

July 01, 2003

HOUSTON—Ablation of thyroid hormone function may help prevent the development of breast cancer, according to a study by Massimo Cristo-fanilli, MD, and his colleagues at M.D. Anderson Cancer Center. This work, a retrospective analysis of the incidence of hypothyroidism in breast cancer patients, was published in the Proceedings for the 94th Annual Meeting of the American Association for Cancer Research, scheduled for April 2003 in Toronto; owing to the outbreak of severe acute respiratory syndrome (SARS), the meeting was postponed until July in Washington, DC. The study (abstract 2903) was prompted by reports showing the ability of thyroid hormones to sustain serum-free proliferation of breast cancer cell lines, as well as work that correlated the presence of antithyroid autoantibodies with a better breast cancer prognosis. Thus it seemed reasonable to expect that primary hypothyroidism, which itself is usually an autoimmune syndrome, might reduce the risk of primary breast cancer, as well as ameliorate the course of disease.

Fatigue Studies Provide Model for Evidence-Based Nursing Practice

July 01, 2003

DENVER, Colorado-Evidencebasedclinical practice has become a hottopic in the current nursing community.Victoria Mock, DNSc, RN, recipient ofthe 2003 Distinguished Researcher Award,related her group’s experience in helpingto develop evidence-based fatigue managementinterventions that have now becomepart of nursing practice. Director ofnursing research at the Kimmel ComprehensiveCancer Center at Johns HopkinsHospital in Baltimore, Dr. Mock has thedistinction of being the only nurse tochair a National Comprehensive CancerNetwork (NCCN) clinical guidelines panel(the committee that developed the firstNCCN guidelines on cancer-related fatigue).

Benefits of Erythropoietic Agents May Extend Beyond Improving Fatigue and Quality of Life

July 01, 2003

DENVER, Colorado-Treatingcancer-related anemia improves qualityof life and may have other potential therapeuticbenefits for cancer patients, accordingto speakers at a cancer-relatedanemia symposium presented in conjunctionwith the 28th Annual Congress of theOncology Nursing Society. The expertpanel also discussed the need for earlierintervention with flexible dosing regimensand outlined potential future applicationsof erythropoietic agents.