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Understanding Metastasis

December 13, 2008

By Beverley Caley

Evidence presented on Saturday at SABCS emphasized that breast cancer metastasis is even more complicated than previously thought. However, researchers are making progress in understanding its complexities and are devising new treatments and treatment strategies based on their improved understanding.

A presentation by Larry Norton, MD, of Memorial Sloan-Kettering Cancer Center, highlighted how modern molecular science is challenging what is known about cancer. One new concept is the “self-seeding” of tumor cells, the idea that tumor cells that have metastasized to another site in the body can return to the primary tumor. This self-seeding by these more aggressive metastatic cells makes the primary tumor stronger by helping it develop more blood vessels and generally promoting its growth. 

SABCS: Estradiol May Restore Breast Tumor Sensitivity to Aromatase Inhibitors

December 13, 2008

By Charles Bankhead, MedPageToday

SAN ANTONIO — Breast tumors that develop resistance to aromatase inhibitors may reacquire sensitivity with low-dose estradiol, according to a small study reported here.

About 30% of a small group with an aromatase inhibitor-resistant- devmalignancyeloped stable disease or better responses with low-dose estradiol, found Matthew Ellis, MB, Ph.D., of Washington University in St. Louis.

Several patients then responded to retreatment with an aromatase inhibitor, Dr. Ellis said at the San Antonio Breast Cancer Symposium.

Ibandronate Safely Reduces Pain in Breast Cancer Patients With Metastatic Bone Disease: Presented at SABCS

December 12, 2008

By Genie Benoist

SAN ANTONIO, Tex — The third-generation amino-bisphosphonate ibandronate produces a profound and sustained pain reduction in breast cancer patients without metastatic bone disease, according to an interim analysis of a large-scale noninterventional study presented at the 31st Annual San Antonio Breast Cancer Symposium (SABCS).

The improvement in pain observed in this study occurred without the need for an increase in analgesics, and treatment was associated with a renal-safety profile comparable to that observed in randomised clinical trials.

HER2 Levels May Aid in Treatment Selection for Metastatic Breast Cancer

December 3, 2008

By American Association for Cancer Research

Newswise — Findings published in the December 1, 2008, issue of Clinical Cancer Research, a journal of the American Association for Cancer Research, show lapatinib benefits women with HER2-positive breast cancer, while women with HER2-negative breast cancer or those who express EGRF alone derive no incremental benefit. In addition, a misclassification of metastatic breast cancer patients by as much as 10 percent prevents some people from receiving optimal therapy.

Lapatinib, an oral chemotherapy agent, inhibits both HER2 and EGRF receptors, leaving unanswered questions about which patients are more likely to benefit. Researchers at the Norris Comprehensive Cancer Center found that HER2 amplification (“HER2-positive”), but not EGRF expression, is correlated with responsiveness to lapatinib. Women with both high and low levels of HER2 amplification respond to lapatinib. However, women with HER2-negative metastatic breast cancers do not respond.

Molecule Linked To Aggressive Cancer Growth And Spread Identified

November 15, 2008

By Science Daily

Researchers at the University of Michigan Comprehensive Cancer Center have found a genetic marker that controls an enzyme present in aggressive and metastatic cancer. The study suggests an absence of microRNA-101 is related to high expression of the protein EZH2, which was previously shown to be active in metastatic cancers. MicroRNA’s are molecules that help regulate gene expression. miR-101 is one of few miRNA’s shown to play such an important role in the development of cancer.

In this study, the researchers found miR-101 is significantly underexpressed in a variety of cancers, including prostate and breast cancer. Essentially, the researchers believe that miR-101 suppresses the EZH2 protein. When miR-101 is lost in cancer, EZH2 expression is uncontrolled, and that haywire in-gene expression leads to more aggressive cancer growth.

Imaging Technology May Relieve Cancer Pain

November 7, 2008

By Methodist Hospital, Houston

Newswise — Physicians at The Methodist Hospital in Houston are studying ways to use magnetic resonance imaging (MRI) and ultrasound to relieve some of the most intense pain resulting from cancer that has spread to the bones.

Bone metastases are one of the most common causes of pain for cancer patients,” said Dr. King Li, chair of the department of radiology at The Methodist Hospital and principal investigator for the trial. “Unfortunately, current treatments to relieve this intense pain are very limited.”

Current painkilling or palliative treatment includes invasive surgery that many late-stage cancer patients cannot tolerate, radiation that damages more tissue than necessary, or nerve ablation. In this study, MRI technology is used to visualize the patient’s anatomy and then aims focused ultrasound waves at the targeted tissue, using low-level heat to ablate, or destroy it, reducing or eliminating the pain. This new method of using MRI-focused ultrasound may provide a completely non-invasive way to relieve pain, Li said.

In earlier clinical studies performed in Europe, the majority of patients reported pain relief within days of treatment.

Patients with metastatic breast cancer (MBC) today live longer and more meaningful lives compared to a decade ago.

November 3, 2008

By Dr Albert Lim Kok Hooi

METASTATIC breast cancer (MBC) is breast cancer that has spread to the bone, lung, liver, brain and other organs. The median survival for patients a decade ago was 24 months. In other words, half the patients lived for less than 24 months and the other half survived more than 24 months. Few patients survived more than five years.

Today, the median survival for MBC is more like 36 months. In fact, a fortunate few may live up to 10 years or more.

Neil Spector: Getting the Right Drug to the Right Patient

October 29, 2008

By Elizabeth Whittington

Herceptin (trastuzumab) was approved in 1998 as treatment for metastatic breast cancer, marking the beginning of the era of targeted therapies. While the drug, which targeted the HER2 receptor on the surface of breast cancer cells, became the next great hope in cancer therapy, Neil Spector, MD, was developing a small-molecule compound at GlaxoSmith-Kline called GW572016, now known as Tykerb (lapatinib).  With the success and publicity of Herceptin, Spector’s team convinced the company to test the compound in breast cancer.

Why cancer’s gaining on us

October 28, 2008

By Rita Arditti

Rita Arditti is one of the founders of the Cambridge-based Women’s Community Cancer Project, a grassroots organization committed to cancer prevention. She has been living with metastatic breast cancer since 1979. http://cache.boston.com/bonzai-fba/File-Based_Image_Resource/dingbat_story_end_icon.gifOctober 27, 2008  THE BOSTON GLOBE

FOR ALL the pink ribbons, breast-cancer awareness events, fund-raisers, and celebrations of “survivorship,” the facts remain grim. In this country, a woman’s lifetime risk of breast cancer is one in eight. In 1975, the risk was about one in 11.

Aromasin® Does Not Improve Survival of Metastatic Hormone-Positive Breast Cancer Compared to Nolvadex®

October 26, 2008

By CancerConsultants.com

Researchers affiliated with the European Organisation for the Research and Treatment of Cancer (EORTC) and the Breast Cancer Cooperative Group have reported that initial treatment of metastatic hormone receptor-positive breast cancer with Aromasin (exemestane) prolongs progression-free survival, but does not improve overall survival compared to Nolvadex (tamoxifen). The details of this study were published in the October 20, 2008 issue of the Journal of Clinical Oncology.1 

The use of the third-generation non-steroidal aromatase inhibitors Aromasin, Arimidex® (anastrozole) and Femara® (letrozole) is becoming increasingly widespread in the treatment of postmenopausal, hormone-positive breast cancer. All three of these agents are approved by the U.S. Food and Drug Administration for the treatment of hormone-positive breast cancer. Aromatase inhibitors have significant activity in patients who have failed Nolvadex. There are also ongoing clinical trials of aromatase inhibitors for prevention of breast cancer in high-risk women. Clinical trials have suggested that aromatase inhibitors may be superior to Nolvadex for adjuvant treatment of post-menopausal women with hormone receptor-positive breast cancer. Three other studies have compared aromatase inhibitiors to Nolvadex for the initial treatment of metastatic breast cancer and found aromatase inhibitors to be somewhat superior or the same as Nolvadex but with no impact on survival.

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