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Abramson Cancer CenterNCI CANCERLIT® Search: Chemotherapy for Breast Cancer - January 2002
National Cancer Institute®
Last Modified: January 1, 2002
Table of Contents
1
UI - 10735887
AU - Kaufmann M; Bajetta E; Dirix LY; Fein LE; Jones SE; Zilembo N; Dugardyn
TI -
JL; Nasurdi C; Mennel RG; Cervek J; Fowst C; Polli A; di Salle E;
Arkhipov A; Piscitelli G; Miller LL; Massimini G
Exemestane is superior to megestrol acetate after tamoxifen failure in
postmenopausal women with advanced breast cancer: results of a phase III
randomized double-blind trial. The Exemestane Study Group.
SO - J Clin Oncol 2000 Apr;18(7):1399-411
AD - Universitatsklinik, Frankfurt, Germany.
PURPOSE: This phase III, double-blind, randomized, multicenter study
evaluated the efficacy, pharmacodynamics, and safety of the oral
aromatase inactivator exemestane (EXE) versus megestrol acetate (MA) in
postmenopausal women with progressive advanced breast cancer who
experienced failure of tamoxifen. PATIENTS AND METHODS: A total of 769
patients were randomized to EXE 25 mg/d (n = 366) or MA (n = 403) 40 mg
four times daily. Tumor response, duration of tumor control,
tumor-related signs and symptoms (TRSS), quality of life (QOL),
survival, and tolerability were evaluated. RESULTS: Overall objective
response (OR) rates were higher in patients treated with EXE than in
those treated with MA (15.0% v 12.4%); a similar trend was noted in
patients with visceral metastases (13.5% v 10.5%). Median survival time
was significantly longer with EXE (median not reached) than with MA
(123.4 weeks; P =.039), as were the median duration of overall success
(OR or stable disease > or = 24 weeks; 60.1 v 49.1 weeks; P =.025), time
to tumor progression (20.3 v 16.6 weeks; P =.037), and time to treatment
failure (16.3 v 15.7 weeks; P =.042). Compared with MA, there were
similar or greater improvements in pain, TRSS, and QOL with EXE. Both
drugs were well tolerated. Grade 3 or 4 weight changes were more common
with MA (17.1% v 7.6%; P =.001). CONCLUSION: EXE prolongs survival time,
time to tumor progression, and time to treatment failure compared with
MA and offers a well-tolerated treatment option for postmenopausal women
with progressive advanced breast cancer who experienced failure of
tamoxifen.
2
UI - 10920131
AU - Chaplain G; Milan C; Sgro C; Carli PM; Bonithon-Kopp C
TI -
Increased risk of acute leukemia after adjuvant chemotherapy for breast
cancer: a population-based study.
SO - J Clin Oncol 2000 Aug;18(15):2836-42
AD - Registre des Cancers Gynecologiques de Cote d'Or, Faculte de Medecine,
Dijon, France.
PURPOSE: To quantify the risk of acute leukemia after adjuvant therapy,
especially chemotherapy with topoisomerase II inhibitors. PATIENTS AND
METHODS: We performed a population-based study in a cohort of 3,093
women younger than 85 years who resided in the French administrative
area of the Cote d'Or, who were given a first diagnosis of primary
breast cancer between 1982 and 1996, and who received a curative
treatment. Information about therapy and follow-up events was obtained
from records of cancer registries that covered this area. RESULTS: Until
leukemia and refractory anemia with excess of blasts, occurred in
patients before any local or distant recurrence. All cases developed in
the first 4 years of follow-up. Compared with the general female
population, the incidence rate of leukemia was significantly increased
in women who received radiotherapy and chemotherapy (standardized
incidence ratio, 28.5; P <.0001). A dose-dependent increase in the risk
of leukemia was observed in women treated with mitoxantrone. Cox
regression analysis showed that the risk of leukemia was significantly
lower in patients treated with anthracyclines than in those treated with
mitoxantrone at cumulative doses >/= 13 mg/m(2). CONCLUSION: The
combination of adjuvant radiotherapy and chemotherapy with mitoxantrone
induces a high risk of acute leukemia in patients with breast cancer. A
leukemogenic effect of chemotherapy with anthracyclines cannot be ruled
out with certainty. However, there are some suggestions that these
topoisomerase II inhibitors might be less leukemogenic than mitoxantrone
and could be preferred in an adjuvant setting.
3
UI - 11118472
AU - Howell A
TI -
Clarification of anastrozole/megestrol acetate trial program design.
SO - J Clin Oncol 2000 Dec 15;18(24):4109
4
UI - 11148553
AU - Allison R; Mang T; Hewson G; Snider W; Dougherty D
TI -
Photodynamic therapy for chest wall progression from breast carcinoma is
an underutilized treatment modality.
SO - Cancer 2001 Jan 1;91(1):1-8
AD - Department of Photodynamic Therapy, Buffalo General Hospital, Buffalo,
New York, USA.
BACKGROUND: Chest wall progression of breast carcinoma after failure of
salvage surgery, radiation, and chemohormonal therapy is a quagmire with
limited therapeutic options. Because photodynamic therapy (PDT) offers
excellent results in cutaneous lesions, PDT may play a role in this
indication. However, to the authors' knowledge, published data for this
subgroup of patients using the only commercially available
photosensitizing agent, Photofrin, often show high treatment morbidity,
limiting PDT's usefulness. The authors report the feasibility of
decreasing the photosensitizer drug dose as a means of exploiting
photobleaching kinetics to improve the therapeutic ratio for these
individuals. METHODS: One hundred two chest wall sites were treated with
PDT after failure of multimodality salvage therapy. In these 9 patients,
lesion size ranged from 0.57 to 9 cm. Photodynamic therapy consisted of
outpatient intravenous infusion of 0.8 mg/kg of Photofrin, followed 48
hours later by 630 nm light treatment of 135-170 J/cm2 delivered by a
KTP:YAG laser coupled to dye unit. Two patients underwent a second PDT
procedure due to new lesion formation. All patients were observed for a
minimum of 6 months, and none was lost to follow-up. RESULTS:
Photodynamic therapy was well tolerated with no photosensitivity
reported. Despite all patients having failed surgery, full dose
radiation and multiagent chemohormonal therapy, chest wall lesions
healed with no scarring. Only 1 (9 cm) lesion took longer than 3 months
to granulate over. The authors were able to evaluate all treatment
sites, and complete response, defined as total lesion elimination, was
noted in 89% of the lesions; reduction without regrowth occurred in 8%
with no response in 3% of the lesions. CONCLUSIONS: Despite having prior
treatment and fragile tissues, low dose Photofrin-induced PDT offers
excellent clinical response with minimal morbidity. These results show
that PDT should play an important role in the management of chest wall
failure from breast carcinoma. Copyright 2001 American Cancer Society.
5
UI - 11410835
AU - Nguyen MC; Stewart RB; Banerji MA; Gordon DH; Kral JG
TI -
Relationships between tamoxifen use, liver fat and body fat distribution
in women with breast cancer.
SO - Int J Obes Relat Metab Disord 2001 Feb;25(2):296-8
AD - Department of Surgery, SUNY Downstate Medical Center, Brooklyn, New York
11203-2098, USA.
Tamoxifen is a nonsteroidal anti-estrogenic drug used for adjuvant
treatment of breast cancer and recently as a chemopreventative agent for
breast cancer and, on an investigational basis, for other cancers. To
date there are case reports of hypertriglyceridemia and fatty liver
disease in tamoxifen users. Fatty liver is associated with visceral
obesity and other components of the metabolic syndrome. Here we
evaluated steatosis and adipose tissue distribution by CT scan in a
cross-sectional study of 32 women on tamoxifen and 39 control women.
Tamoxifen users had more visceral adipose tissue (VAT) and more liver
fat than controls. This is the first study to demonstrate that fatty
liver and intra-abdominal fat accumulation are common in breast cancer
patients receiving tamoxifen. Prospective studies of tamoxifen should
monitor metabolic changes in obese women with or without breast cancer.
6
UI - 11181691
AU - Ghalie RG; Goodkin DE
TI -
Secondary leukemia after adjuvant chemotherapy for breast cancer.
SO - J Clin Oncol 2001 Feb 15;19(4):1231-3
7
UI - 11370490
AU - Mendenhall NP
TI -
Breast-conserving therapy for early-stage breast cancer.
SO - Hematol Oncol Clin North Am 2001 Apr;15(2):219-42
AD - Department of Radiation Oncology, University of Florida College of
Medicine, Gainesville, Florida, USA. mendenan@shands.ufl.edu
In most other organs (extremities, bladder, rectum, larynx, or eye), the
acceptance of organ-conserving therapy into standard oncologic practice
has required only the demonstration of feasibility and efficacy--not
equivalency with the radical surgical alternative. BCT was not generally
accepted as standard oncologic practice until the maturation of numerous
prospective randomized trials that universally demonstrated equivalence
in disease control outcomes and survival with mastectomy. In fact, the
acceptance of BCT as standard therapy in many parts of the United States
actually lagged more than a decade behind sentinel publications
documenting proof of equivalency with mastectomy. Even today,
investigators continue to search for a subset of breast cancer patients
who will have better disease control with radical surgery. BCT stands as
not only the best-studied example of organ-conserving therapy but one of
the most rigorously tested therapies in all of medicine.
Breast-conserving therapy requires a multidisciplinary approach with
close coordination among team members from diagnosis through
surveillance following treatment. The surgeon must be willing to assess
and re-excise margins, to mark the tumor bed with clips, and to use
sentinel node biopsy in appropriate patients. The radiation oncologist
must be willing to use CT planning, paying close attention not only to
coverage of target tissues but to avoidance of critical normal tissues.
The medical oncologist must work closely with the surgeon and radiation
oncologist to determine the optimal sequencing of therapies and
selection of systemic agents. All must recognize special circumstances
where genetic counselling may be beneficial, psychosocial support may be
needed, or BCT may not be the best choice for patients. When used
appropriately, BCT produces maximal disease control and quality of life
while minimizing iatrogenic functional, cosmetic, and psychologic
sequelae in patients with early-stage breast cancer. BCT serves as a
model for the optimal combination of surgery and radiation in
organ-preserving cancer therapy.
8
UI - 11417845
AU - Melichar B; Touskova M; Dvorak J; Jandik P; Kopecky O
TI -
The peripheral blood leukocyte phenotype in patients with breast cancer:
effect of doxorubicin/paclitaxel combination chemotherapy.
SO - Immunopharmacol Immunotoxicol 2001 May;23(2):163-73
AD - Department of Oncology & Radiotherapy, Charles University Medical School
& Teaching Hospital, Hradec Kralove, Czech Republic.
Presence of functional immune system is critical for any attempt aimed
at improving survival of breast cancer patients by strategies based on
immune system manipulation. We evaluated by flow cytometry the phenotype
of peripheral blood leukocyte of 43 breast cancer patients. In 11
patients, the phenotype was evaluated before and during the chemotherapy
by combination of doxorubicin and paclitaxel (AT). Compared with
controls breast cancer patients had significantly higher relative and
absolute numbers of CD3 HLA-DR+, CD3+CD69+ and CD14+CD16+, and
significantly lower percentages of CD3 and CD8+CD28+ cells. After one
cycle of AT, the absolute numbers of CD3 , CD3+CD4+, CD3+CD8+ and
CD8+CD28+ cells increased significantly. Present data show a presence of
T-cell activation in breast cancer patients. Administration of AT may
lead to an increase in functional T-cells in peripheral blood,
indicating a potential for combining chemotherapy with immunotherapy in
the treatment of breast cancer patients.
9
UI - 11432615
AU - Razis ED; Fountzilas G
TI -
Paclitaxel: epirubicin in metastatic breast cancer--a review.
SO - Ann Oncol 2001 May;12(5):593-8
AD - 1st Department of Medical Oncology, Hygeia Hospital, Athens, Greece.
edrazis@hol.gr
BACKGROUND: Treatment of metastatic breast cancer (MBC) with paclitaxel
(T) and doxorubicin has yielded high response rates but the regimen is
associated with significant cardiac toxicity. Epirubicin (E) is a less
cardiotoxic anthracycline which has also been combined with paclitaxel
in the treatment of MBC. MATERIALS AND METHODS: This paper is a review
of studies evaluating the pharmacokinetics, toxicity profile, and
efficacy of the ET combination in MBC. RESULTS: The ET combination has
been studied extensively in Europe. The unique pharmacokinetics of the
combination do not lead to the accumulation of cardiotoxic metabolites
as in the case of the doxorubicin-paclitaxel combination. In terms of
efficacy, the ET combination yields an overall response rate of 50%-70%
and complete response rate (CR) 10%-15% in MBC in the same range as the
more recent doxorubicin paclitaxel studies. CONCLUSION: In summary the
ET combination is safe and effective in MBC. It is less cardiotoxic than
the doxorubicin paclitaxel combination. Further studies with ET in both
the adjuvant setting and in MBC are in progress.
10
UI - 11432617
AU - Villalona-Calero MA; Blum JL; Jones SE; Diab S; Elledge R; Khoury P; Von
TI -
Hoff D; Kraynak M; Moczygemba J; Kromelis P; Griffin T; Rowinsky EK
A phase I and pharmacologic study of capecitabine and paclitaxel in
breast cancer patients.
SO - Ann Oncol 2001 May;12(5):605-14
AD - Institute for Drug Development, Cancer Therapy and Research Center, San
Antonio, Texas, USA. villalona-1@medctr.osu.edu
BACKGROUND: Based on preclinical studies demonstrating that treatment
with paclitaxel upregulates intratumoral thymidine phosphorylase
(dTHdPase), which catalyzes the final step in the conversion of the oral
fluoropyrimidine capecitabine to 5-fluorouracil (5-FU), as well as the
overlapping spectra of activity for these agents, particularly in
metastatic breast cancer, this phase I study evaluated the feasibility
of administering capecitabine on an intermittent schedule in combination
with paclitaxel in previously-treated patients with locally advanced or
metastatic breast cancer. The study also sought to recommend doses for
subsequent disease-specific studies, identify clinically significant
pharmacokinetic interactions, and detect preliminary antitumor activity.
PATIENTS AND METHODS: Nineteen previously treated women with metastatic
breast cancer whose prior treatment included neither paclitaxel or
capecitabine received one hundred one courses of capecitabine and
paclitaxel. Paclitaxel was administered as a three-hour intravenous
(i.v.) infusion at a fixed dose of 175 mg/m2 and capecitabine was
administered as 2 divided daily doses for 14 days followed by a
seven-day rest period every 3 weeks. The dose of capecitabine was
increased from a starting dose of 1650 mg/m2/d. The plasma sampling
scheme in the first course permitted characterization of the
pharmacokinetics of each agent given alone and concurrently to detect
major pharmacokinetic interactions. RESULTS: Palmar plantar
erythrodysesthesia (hand foot syndrome) and neutropenia were the
principal dose-limiting toxicities (DLT). Other toxicities included
diarrhea and transient hyperbilirubinemia. Three of eight new patients
treated with capecitabine 2000 mg/m2/d and paclitaxel 175 mg/m2
experienced DLT in the first course, whereas none of eleven new patients
treated with capecitabine 1650 mg/m2/d and paclitaxel 175 mg/m2
developed DLT. Pharmacokinetic studies indicated that capecitabine did
not grossly affect the pharmacokinetics of paclitaxel, and there were no
major effects of paclitaxel on the pharmacokinetics of capecitabine and
capecitabine metabolites. However, AUC values for the major 5-FU
catabolite, fluorobeta-alanine (FBAL), were significantly lower in the
presence of paclitaxel. Two complete and seven partial responses (56%
response rate) were observed in sixteen patients with measurable
disease; four of six patients whose disease was previously treated with
high-dose chemotherapy and hematopoietic stem-cell support had major
responses. Seven of nineteen patients had stable disease as their best
response. CONCLUSIONS: Recommended combination doses of capecitabine on
an intermittent schedule and paclitaxel are capecitabine 1650 mg/m2/d
orally for 14 days and paclitaxel 175 mg/m2 i.v. every 3 weeks. The
favorable preclinical interactions between capecitabine and paclitaxel,
as well as the acceptable toxicity profile and antitumor activity in
patients with metastatic breast cancer, support further clinical
evaluations to determine an optimal role for the combination of
capecitabine and paclitaxel in breast cancer and other relevant
malignancies.
11
UI - 11432629
AU - Gazet JC; Ford HT; Gray R; McConkey C; Sutcliffe R; Quilliam J; Makinde
TI -
V; Lowndes S; Coombes RC
Estrogen-receptor-directed neoadjuvant therapy for breast cancer:
results of a randomised trial using formestane and methotrexate,
mitozantrone and mitomycin C (MMM) chemotherapy.
SO - Ann Oncol 2001 May;12(5):685-91
AD - Combined Breast Clinic, St. George's Hospital, London, UK.
BACKGROUND: We wanted to determine whether neoadjuvant systemic
chemoendocrine therapy guided by the estrogen receptor (ER) status of
the primary breast cancer, followed by conventional surgery and/or
radiotherapy, reduces local and distant recurrence and improves survival
compared with adjuvant treatment given conventionally postoperatively.
PATIENTS AND METHODS: Two hundred ten patients with primary breast
cancer (T1-T4, N0, N1-2) were randomised to receive treatment with
neoadjuvant chemoendocrine therapy or conventional post-operative
chemoendocrine therapy. Systemic therapy was based on the estrogen
receptor (ER) status of the primary tumour obtained by trucut core
biopsy. ER-negative patients received MMM chemotherapy (methotrexate (30
mg/m2), mitozantrone (7 mg/m2) and mitomycin (7 mg/m2) three-weekly for
three months and ER-positive patients who were premenopausal received
goserelin (3.75 mg monthly), and post menopausal women formestane (250
mg every two weeks) over three months. RESULTS: With a minimum of five
years follow-up, there is no evidence of any survival benefit from the
pretreatment neoadjuvant therapy regimen, with five year overall
survival being 79% +/- 4.7% (neoadjuvant) and 87% +/- 3.4% (adjuvant).
Similarly, there was no apparent benefit in terms of disease-free
survival. There was, however, a significant reduction in the incidence
of distant metastases in responders (4 of 51; 8%) compared with
non-responders (17 of 49; 35%) (P < 0.01). There was a reduction in the
need for surgery in responding patients with T1 and T2 tumours, since 10
of 74 (14%) had no detectable residual tumour, without any apparent
increase in the risk of local or distant recurrence. CONCLUSION: In this
study neoadjuvant treatment with endocrine or chemotherapy provided no
obvious survival benefit to women with breast cancer. However, it does
allow avoidance of surgery in some cases. Also, the patients whose
tumours respond to neoadjuvant systemic therapy have a lower incidence
of distant metastases after five year follow-up compared to those whose
tumours fail to respond.
12
UI - 11432636
AU - Schnetzler B; Popova N; Collao Lamb C; Sappino AP
TI -
Coronary spasm induced by capecitabine.
SO - Ann Oncol 2001 May;12(5):723-4
13
UI - 11440031
AU - Tiling R; Linke R; Untch M; Richter A; Fieber S; Brinkbaumer K; Tatsch
TI -
K; Hahn K
18F-FDG PET and 99mTc-sestamibi scintimammography for monitoring breast
cancer response to neoadjuvant chemotherapy: a comparative study.
SO - Eur J Nucl Med 2001 Jun;28(6):711-20
AD - Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich,
Germany. tiling@nuk.med.uni-muenchen.de
Presurgical neoadjuvant chemotherapy has shown promise in the treatment
of locally advanced breast carcinoma (LABC). Response assessment by
clinical examination and mammography is difficult. This study evaluated
and compared fluorine-18 fluorodeoxyglucose positron emission tomography
(18F-FDG-PET) and technetium-99m sestamibi scintimammography (SMM) as
potential methods for the early assessment of tumour response to
neoadjuvant chemotherapy in patients with LABC. Seven patients underwent
PET and SMM [planar and single-photon emission tomography (SPET)] before
beginning chemotherapy, after the first and second cycles of
chemotherapy and after completing chemotherapy prior to surgery. PET and
SMM results were evaluated visually and semi-quantitatively by
calculating standardised uptake values (SUV) and tumour/lung ratios in
the initial and subsequent studies. The findings were correlated with
the initial clinical and mammographic findings and the final
histopathological diagnoses. There was a highly significant correlation
between SUVmean, SUVmax and the tumour/lung ratio determined with
SMM-SPET in the studies performed before and during neoadjuvant
chemotherapy. All three patients with complete remission showed
decreasing FDG and sestamibi uptake as early as 8 days after therapy. In
the presurgical study, increased sestamibi and FDG uptake was no longer
evident. Three patients had partial remission with clearly reduced but
persisting focal FDG and sestamibi uptake after neoadjuvant therapy. One
patient who did not respond to therapy had unchanged intense tracer
uptake during chemotherapy that was evident with both techniques. An
early decline in glucose metabolism or sestamibi uptake 8 days after
beginning therapy did not necessarily predict complete tumour remission
in the further course of chemotherapy. On the other hand, increased
tracer uptake after the first cycle did not exclude a partial tumour
response. After the second chemotherapeutic cycle both techniques were
able to distinguish between complete and partial/no response. There was
a good correlation between preoperative FDG and sestamibi uptake and the
histopathologically determined tumour size. However, small residual
invasive tumours in patients with clinically complete remission could
not be visualised with either technique. The preliminary data
demonstrate that sestamibi SMM is as useful as FDG-PET for the
monitoring of tumour response to neoadjuvant chemotherapy.
14
UI - 11456056
AU - Esserman L; Kaplan E; Partridge S; Tripathy D; Rugo H; Park J; Hwang S;
TI -
Kuerer H; Sudilovsky D; Lu Y; Hylton N
MRI phenotype is associated with response to doxorubicin and
cyclophosphamide neoadjuvant chemotherapy in stage III breast cancer.
SO - Ann Surg Oncol 2001 Jul;8(6):549-59
AD - Department of Surgery, University of California, San Francisco, USA.
laura.esserman@ucsfmedctr.org
BACKGROUND: The preferred management for women with stage II or locally
advanced breast cancer (LABC) is neoadjuvant chemotherapy. Pathologic
response to chemotherapy has been shown to be an excellent predictor of
outcome. Surrogates that can predict pathologic response and outcome
will fuel future changes in management. Magnetic resonance imaging (MRI)
demonstrates that patients with LABC have distinct tumor patterns. We
investigated whether or not these patterns predict response to therapy.
METHODS: Thirty-three women who received neoadjuvant doxorubicin and
cyclophosphamide chemotherapy for 4 cycles and serial breast MRI scans
before and after therapy were evaluated for this study. Response to
therapy was measured by change in the longest diameter on the MRI.
RESULTS: Five distinct imaging patterns were identified: circumscribed
mass, nodular tissue infiltration diffuse tissue infiltration, patchy
enhancement, and septal spread. The likelihood of a partial or complete
response as measured by change in longest diameter was 77%, 37.5%, 20%,
and 25%, respectively. CONCLUSIONS: MRI affords three-dimensional
characterization of tumors and has revealed distinct patterns of tumor
presentation that predict response. A multisite trial is being planned
to combine imaging and genetic information in an effort to better
understand and predict response and, ultimately, to tailor therapy and
direct the use of novel agents.
15
UI - 11475386
AU - Jansen SJ; Kievit J; Nooij MA; Stiggelbout AM
TI -
Stability of patients' preferences for chemotherapy: the impact of
experience.
SO - Med Decis Making 2001 Jul-Aug;21(4):295-306
AD - Department of Clinical Oncology, Leiden University Medical Center, The
Netherlands. S.J.T.Jansen.bsl@LUMC.nl
BACKGROUND: Studies have shown that utilities for a particular
treatment, elicited by means of a hypothetical treatment scenario, may
remain stable within the same patients when examined before, during, and
after experiencing that treatment (within-group stability). However,
other studies have found that utilities for a particular health state
may differ between patient groups who are and who are not experiencing
the particular health state (between-group differences). OBJECTIVE: The
authors evaluated this apparent contradiction in the case of adjuvant
chemotherapy for breast cancer. A related purpose was to examine whether
a chemotherapy scenario adequately reflects the patients' own
experiences with chemotherapy. METHOD: Forty-three patients with
early-stage breast cancer evaluated their actually experienced health
state and a chemotherapy scenario before, during, and after undergoing
adjuvant chemotherapy (chemotherapy group). A control group of 51
patients for whom chemotherapy was not part of the treatment plan was
interviewed at similar points in time. Utilities were elicited by means
of a visual analog scale (VAS), a chained time trade-off (TTO), and a
chained standard gamble (SG). RESULTS: The utilities for the
chemotherapy scenario remained relatively stable over time in the 2
patient groups. Furthermore, the chemotherapy scenario was evaluated
more positively by patients in the chemotherapy group than by control
patients (e.g., utilities before chemotherapy: VAS 0.69 vs. 0.50, TTO
0.88 vs. 0.50, SG 0.92 vs. 0.58, all Ps < 0.01). Finally, patients in
the chemotherapy group evaluated their actually experienced health
states during chemotherapy higher than the chemotherapy scenario that
was assessed at the same time (VAS 0.79 vs. 0.69, TTO 0.93 vs. 0.87, SG
0.97 vs. 0.96, all Ps < 0.05). CONCLUSIONS: Both within-group stability
and between-group differences were found. A possible explanation for
within-group stability may be that the chemotherapy scenario did not
fully correspond to the patients' actual experiences with chemotherapy
("noncorresponding description"). Therefore, preferences did not change
even when the patients' own clinical health status had changed. The
between-group differences may be explained by "anticipated adaptation."
Both explanations may work together to explain why utilities remain
stable within the same patients but differ between different patient
groups.
16
UI - 11484972
AU - Isambert N; Correia M; Cercueil JP; Zanetta S; Osmak L; Flesch M; Krause
TI -
D; Coudert B; Fargeot P; Bedenne L; Chauffert B
Hepatic arterial infusion of cisplatin diluted in hypotonic 25 g/l
glucose solution administered in balloon-occluded hepatic artery:
experimental rationale and clinical pilot study.
SO - J Exp Clin Cancer Res 2001 Jun;20(2):183-8
AD - Dept. of Medical Oncology, Regional Anticancer Center Georges-Francois
Leclerc, Dijon, France.
Reduced osmolarity in incubation medium was previously shown to increase
in vitro cellular accumulation and cytotoxicity of cisplatin on cancer
cells. We confirmed in the present work that cisplatin diluted in an
hypotonic 25 g/l glucose solution (124 mOsm) was dramatically more
cytotoxic in vitro than cisplatin diluted in normotonic 9 g/l NaCl (300
mOsm) on the human HT29 colon and MCF7 breast cancer cells. We conducted
then a pilot clinical study on the administration of cisplatin diluted
in hypotonic 25 g/l glucose solution given through the balloon-occluded
hepatic artery for the treatment of liver metastases from colon or
breast cancer tumors. Nine patients (5 men, 4 women; mean age 58, range:
44-71) with confirmed isolated, unresectable metastases from colorectal
(7) or breast (2) tumors were included in this study and a total of 23
cycles were administered (2.55 per patient; range 1-5) with an average
dose of 50 mg cisplatin (range: 12.5-100). Hepatic artery dissection due
to balloon injury with partial or complete arterial obstruction were
encountered in 2 patients. Pain in the liver and epigastric area was the
main symptom which was constant and intense during the IAH cisplatin
injection. Fever > 38 degrees C was observed in 15/23 cycles and
increase of creatinine in 1/23 cycles. Transient increase of hepatic
transaminases without change in prothrombin time was registered in all
patients. However one patient who received the highest dose of 100 mg
cisplatin developed a persistent but reversible clinical jaundice and a
transient increase in prothrombin time. One patient achieved a partial
response (12 weeks), 7 had stable disease (mean duration: 6 weeks) and
one had a progressive disease. Hepatic arterial infusion of cisplatin
diluted in hypotonic 25 g/l glucose solution and administered through
the balloon-occluded hepatic artery is a feasible approach. Total dose
of cisplatin in hypotonic glucose solution will not exceed 80 mg by cure
in a further phase II study.
17
UI - 11499684
AU - Anonymous
TI -
Doxorubicin/paclitaxel combination does not expose breast cancer
patients to excessive cardiac risk.
SO - Oncology (Huntingt) 2001 Jul;15(7):830
18
UI - 11499691
AU - Anonymous
TI -
Gemcitabine active in patients with metastatic breast cancer.
SO - Oncology (Huntingt) 2001 Jul;15(7):917
19
UI - 11487711
AU - Bell R
TI -
Duration of therapy in metastatic breast cancer: management using
Herceptin.
SO - Anticancer Drugs 2001 Aug;12(7):561-8
AD - Andrew Love Cancer Centre, 70 Swanston Street, Geelong, Victoria 3220,
Australia. richardb@barwonhealth.org.au
Despite progressive developments in therapeutic interventions, including
surgery, radiotherapy and chemotherapy, there has been no major
improvement in the survival of women with metastatic breast cancer
(MBC). Based on knowledge of tumor growth patterns, approaches
addressing this issue have included increasing chemotherapy dose or dose
density and extending the duration of therapy. However, only the latter
approach has resulted in improved clinical benefit, although not
survival; and its use is restricted by the cumulative toxicity of
chemotherapeutic agents. Therefore, the best hope for improved survival
lies with new classes of anticancer drug and particularly biological
agents. This review focuses on the first oncogene-targeted therapy for
human epidermal growth factor receptor-2 (HER2)+ MBC patients. The
humanized anti-HER2 monoclonal antibody
Cancer Types
Bone Cancer
Brain Tumors
Breast Cancer
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