Thursday, December 17, 2009
The 32nd Annual San Antonio Breast Cancer Symposium took place Dec. 9 to 13 and attracted more than 8,500 scientists and other professionals from 90 different countries. The meeting featured more than 1,000 presentations on the experimental biology, etiology, prevention, diagnosis, and therapy of breast cancer and premalignant breast disease. Highlights included four press conferences which addressed bisphosphonates, drugs in the pipeline, new treatment paradigms, and patient management and prognosis.
During the bisphosphonates press conference, Rowan Chlebowski, M.D., of the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, presented a new analysis of data from the Women's Health Initiative study of more than 150,000 generally healthy postmenopausal women, which included 2,216 women who were using bisphosphonates at study entry. Chlebowski and colleagues found that bisphosphonate use was associated with a 32 percent reduction in invasive breast cancers.
"This is a drug that has a well-defined toxicity profile, is in widespread use, so if this result is confirmed you could extend the number of women who are taking the drug," Chlebowski said. "On a more basic level, it suggests there's an agent with relatively mild toxicity that can influence receptor-negative breast cancer. If that's the case, some preclinical biology could be done to see what that mechanism might be. But even now, it might represent something a woman could consider if she's considering bisphophonate use for low bone mass."
"It would be nice to do prospective randomized trials," Chlebowski added. "One could easily imagine how a bisphosphonate that supports bone could be coupled with an aromatase inhibitor which reduces contralateral breast cancer would make a very nice combination which would have a huge impact on breast cancer incidence."
In another study presented at the bisphosphonates press conference, Israeli researchers studied 4,575 postmenopausal women and found that the use of bisphosphonates for at least one year was associated with a 29 percent reduced risk of breast cancer. They also found that bisphosphonate users who developed breast cancer were more likely than nonusers to have estrogen receptor-positive tumors and less likely to have poorly differentiated tumors.
"These tumors are the type that are associated with a better prognosis," lead researcher Gad Rennert, M.D., of Israel Institute of Technology and Clalit National Cancer Control Center in Haifa, said in a statement.
During the press conference on new treatment paradigms, Kimberly L. Blackwell, M.D., of the Duke University Medical Center in Durham, N.C., presented a study in which 296 women with metastatic breast cancer were randomly assigned to receive either 1,500 mg per day of lapatinib alone or 1,000 mg per day of lapatinib plus 2 mg/kg of trastuzumab every week.
Compared to lapatinib alone, the researchers found that the combination therapy extended survival by more than four months. They also noted a trend toward a 25 percent reduced risk of death.
According to Blackwell, the study broke new ground because it showed improved survival without the use of endocrine therapy or chemotherapy. "We demonstrated the effectiveness of combined targeted therapy; no other study has examined this combination in a phase III, randomized design," Blackwell said in a statement.
In another noteworthy study presented at the meeting, which was published online Dec. 10 in The Lancet Oncology, Kathy S. Albain, M.D., of the Loyola University Chicago Stritch School of Medicine, and colleagues used the 21-gene recurrence assay to analyze 367 tumor specimens from women with node-positive, estrogen receptor-positive breast cancer who were treated with either tamoxifen alone or tamoxifen plus chemotherapy. In the combination therapy group, they found that a recurrence score below 18 predicted no benefit from the addition of chemotherapy, while a score at or above 31 predicted a significant benefit from the addition of chemotherapy on disease-free survival.
"A low recurrence score identifies women who might not benefit from anthracycline-based chemotherapy, despite positive nodes," Albain and colleagues conclude.
Joseph A. Sparano, M.D., of the Albert Einstein Medical College of Medicine in Bronx, N.Y., presented an unexpected finding that African-American women with hormone receptor-positive, HER-2-normal breast cancer have significantly lower disease-free and overall survival than their Caucasians counterparts. They found that this racial disparity persisted even after controlling for such factors as higher incidence of more advanced-stage disease, more aggressive triple-negative disease, disparities in medical care, and comorbidities.
"We found that black patients exhibited similar adherence to the chemotherapy and hormonal therapy, and they didn't do worse if they had other breast cancer subtypes," Sparano said in a statement. "This indicates that black women with hormone receptor-positive breast cancer are more prone to have disease recurrence despite state of the art medical care."
SABCS: Chemo Plus Herceptin Found to Improve Outcomes
MONDAY, Dec. 14 (HealthDay News) -- In women who undergo surgery to treat Stage I to III invasive HER2+ breast cancer, postoperative treatment with concurrent chemotherapy and Herceptin significantly improves disease-free survival, according to research presented at the San Antonio Breast Cancer Symposium, held from Dec. 9 to 13.
SABCS: Anti-Estrogens May Lower Lung Cancer Mortality
MONDAY, Dec. 14 (HealthDay News) -- In breast cancer patients, anti-estrogens may significantly reduce the risk of dying from lung cancer, according to research presented at the San Antonio Breast Cancer Symposium, held from Dec. 9 to 13.
SABCS: Obesity, Alcohol May Affect Breast Cancer Outcomes
MONDAY, Dec. 14 (HealthDay News) -- Obesity is associated with poorer breast cancer outcomes, and moderate to heavy alcohol consumption may increase the risk of breast cancer recurrences, according to research presented at the San Antonio Breast Cancer Symposium, held from Dec. 9 to 13.
SABCS: MRI May Provide Benefit in Breast Screenings
FRIDAY, Dec. 11 (HealthDay News) -- Magnetic resonance imaging (MRI) scans may be helpful for earlier breast cancer diagnoses in high-risk patients, finding more cancers at less advanced stages, according to research presented at the San Antonio Breast Cancer Symposium, held from Dec. 9 to 13.
SABCS: Combo Treatment Beneficial in Breast Cancer
FRIDAY, Dec. 11 (HealthDay News) -- In postmenopausal women with hormone-receptor positive, node-positive breast cancer, addition of chemotherapy to standard tamoxifen treatment significantly improves disease-free survival compared to tamoxifen alone, according to a study published online Dec. 11 in The Lancet to coincide with the annual San Antonio Breast Cancer Symposium, held from Dec. 9 to 13.
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