Tamoxifen, raloxifene cut breast cancer risk in half

Women at high risk can take either drug as preventive therapy, researchers in a seven-year study say.

Two drugs taken by women at high risk for breast cancer — tamoxifen and raloxifene — both reduce the risk of the disease by about 50% in high-risk post-menopausal women while they are taking the medications, researchers said Monday. The benefits of raloxifene fall off more quickly once women stop taking them, however, and the increased benefits of tamoxifen come at a price: a higher risk of uterine cancer, blood clots and cataracts — although the absolute risks of all three remain low.

"These are relatively inexpensive drugs that reduce breast cancer by about 50% with side effects that are modest," said Dr. Gabriel N. Hortobagyi of the University of Texas M.D. Anderson Cancer Center in Houston, one of the researchers. "We need to reassess why we are not using these drugs more broadly," he said at a news conference at a meeting of the American Assn. of Cancer Research, where the results were presented.

The new results represent an extension of a clinical trial that was first reported in 2007 and allow refinement of the researchers' earlier conclusions. But the basic message is that women can confidently take either drug to sharply reduce their risk of dying from breast cancer.

"If they can't tolerate their first choice, they can take advantage of the second drug," said Dr. Larry Wickerham of Allegheny General Hospital in Pittsburgh, another researcher on the team.

The trial enrolled 19,747 post-menopausal women over the age of 35 who had an above-normal risk of breast cancer because they had breast cancer genes or a family history of the disease. While the average 60- to 64-year-old woman has about a 1.66% risk of developing breast cancer over a five-year period, the women in the study averaged twice that risk, and some had an even higher risk. (Women can calculate their own risk at http://www.cancer.gov/bcrisktool).

Women who had uncontrolled diabetes or hypertension were excluded from the trial, as were those at a high risk for stroke or blood clots.

The women were given either tamoxifen (brand name Nolvadex, also available generically) or raloxifene (brand name Evista) daily for five years.

The initial results released after the end of that five years showed that both drugs reduced the risk of breast cancer by 50%. Based on those findings, the Food and Drug Administration approved the use of raloxifene to prevent breast cancer in high-risk post-menopausal women. Tamoxifen was already approved in both pre- and post-menopausal high-risk women.

The new report, which provides an additional 21 months of follow-up, shows that the benefits of tamoxifen continued after the women stopped taking it, but those of raloxifene fell off quickly. Over the nearly seven years of the study, tamoxifen reduced risk by 50%, but raloxifene reduced it by only 38%. That translates to 247 cases of invasive breast cancer (tumors that are likely to spread beyond the breast) among 9,736 women who took tamoxifen and 310 cases in the 9,754 women who took raloxifene.

Previous studies have shown that tamoxifen provides protection for at least seven to 10 years after women stop taking the drug.

About half the women in the trial had previously had hysterectomies and were not at risk of uterine cancer. Among the rest, 65 of 4,739 women in the tamoxifen group developed uterine cancer, compared with 37 of the 4,717 in the raloxifene group.

The raloxifene group also had 28% fewer blood clots in a major vein and 20% fewer blood clots in the lungs, but the absolute number of events was low in both groups.

The fact that raloxifene has fewer side effects may induce more women to adopt preventive therapy, said Dr. Jack Jacoub, an oncologist at Memorial Care Cancer Institute at Orange Coast Memorial Medical Center in Fountain Valley, who was not involved in the research.

In the United States, "we have actually had difficulty getting women to accept preventive measures for breast cancer, and the primary deterrent has been the toxicity" of tamoxifen, Jacoub said. If these results are presented to women properly, "I think we will see more women receiving this therapy."

The study was funded by the National Cancer Institute, which provides more information about the results at http://www.cancer.gov/newscenter/STARresultsQandA.

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Diabetes Drug Metformin May Reduce Risk of Breast Cancer

Metformin, a medication commonly used in the treatment of type 2 diabetes, may reduce the risk of breast cancer when used for more than five years, according to a new study published by the American Diabetes Association. The study adds fuel to increasing evidence of metformin's potential anti-cancer effects.

The study, led by Dr. Christoph R. Meier of Switzerland, followed more than 1,000 women in the U.K. using the drug to treat diabetes. Women using metformin for more than five years were at a 56 percent lower risk of breast cancer than those who never took the drug.

The study was relatively small, and while a direct cause and effect link between the drug and the reduced risk has not been established, researchers believe the connection may be related to metformin's actions on a key metabolic enzyme known as AMP-activated protein kinase as well as its insulin-reducing activity.

The study comes just days after researchers at the American Association for Cancer Research presented findings suggesting metformin may lower the risk of lung cancer in smokers.

During its 15 years in use, metformin has become a popular drug for the treatment type 2 diabetes, a condition in which insulin does not properly carry sugar out of the bloodstream and into cells. Metformin helps regulate blood sugar levels and prevent complications in patients with the disease by reducing the amount of glucose absorbed in the stomach and produced in the liver while also enhancing the performance of insulin.

As the evidence for metformin's anti-cancer effects rises, additional studies addressing the medication's potential in cancer reduction are in the works.

Additional information about drugs and drug side effects may be found on Drugwatch.com.

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New Route To Potential Breast Cancer Cure Discovered

UK scientists have discovered a new route to a potential cure for breast cancer, one that focuses on how the cancer manipulates genetic pathways to spread through the body, rather than on how tumors develop in the first place. They are already working on a new drug to switch off the cancer's effect on the pathways and say it could be ready in a couple of years, but experts suggest this could be rather optimistic.

The landmark study was the work Dr Justin Stebbing of Imperial College London (ICL) and other colleagues from ICL and also from the Howard Hughes Medical Institute, Cold Spring Harbor Laboratory in New York, USA. They have written a paper on it in the 24 August online before print issue of the Proceedings of the National Academy of Sciences, PNAS.

Stebbing, who is senior lecturer and consultant medical oncologist at ICL was reported by the Daily Express as telling the media that the new discovery was a "step on the way" to a potential cure for breast cancer.

"It helps us understand the way breast cancer cells grow and divide and if we understand this then we understand how to stop it," said Stebbing.

Breast cancer is the most common cancer of women in the western world, in Britain alone it kills 12,000 women a year.

In most cases the cancer depends on estrogen to fuel tumor growth, and current treatments focus on inhibiting the activity of the estrogen receptor. These treatments, for example tamoxifen, have been very successful at reducing deaths from breast cancer.

"The estrogen receptor is incredibly important in breast cancer," said Stebbing.

"Most of the treatments around treating breast cancer are blocking it or inhibiting the oestrogen but despite that about half of all women relapse," he added.

Many patients relapse because they eventually become resistant to hormone therapies.

Cancer is essentially a process where cell growth gets out of control. One of the ways that healthy cells stop growth getting out of control is via microRNA molecules that use genetic pathways to control various cellular processes in the body, such as making proteins.

As Stebbing explained:

"The way to cure breast cancer or any cancer is by fundamental biological understanding of what turns cells on and off, stopping the way tumours grow."

Stebbing and colleagues' breakthrough has been to discover how cancer cells switch off the microRNA molecules that control cell division to unleash the growth and proliferation of malignant cells.

"We can use these microRNAs as a new treatment and make them do what current drugs don't do," said Stebbing.

He said they had found a new microRNA pathway that the estrogen receptor activates. In normal cells estrogen encourages the production of microRNAs, but then as more of them are produced, they switch off estrogen activity, and this keeps cell division under control. Stebbing described this as a "perfect circle".

"But in breast cancer cells, production of the molecules is turned off," said Stebbing, and this is how the control over cell division is then lost and the malignant cells proliferate.

So their aim is to produce a drug that restores the "perfect circle" by stopping the deactivation of the microRNAs.

"If we know how to stop it then we can cure it. This only applies in oestrogen positive breast cancer but this could save millions of lives," said Stebbing.

Experts welcomed the discovery but had reservations about a drug being available soon.

According to the Daily Express, Dr Laura Bell, of Cancer Research UK, said it was far too early to say whether the discovery will "translate into clinical benefits for people with cancer". She said there was still a lot of work to be done.

Agreeing, Dr Alexis Willett, of Breakthrough Breast Cancer reportedly said, "this research is still at a very early stage".

Source : www.medicalnewstoday.com

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Death of breast cancer stems cells touted in new drug compound

A new study demonstrates the impact of a new drug compound on killing breast cancer stem cells, a major breakthrough that could have lasting positive implications for other cancers.

Breast cancer stem cells - the master blueprint cells that govern the deadly onset and continuation of breast cancer - are now in the cross-hairs of a new drug compound.

In a report published in the journal Cell, U.S. researchers working out of the Massachusetts Institute of Technology detailed their findings - saying that the new compound is designed to specifically hit the breast cancer stem cells, leaving the body's necessary stem cells alone and intact.

"There is a lot of evidence to suggest now that these cells are responsible for many of the recurrences that are observed after treatment has stopped," Piyush Gupta of the Massachusetts Institute of Technology and the Broad Institute, told Reuters.
The researchers findings are significant, as cancer stem cells are often difficult to identify - as they change rapidly into fully functioning cancer cells. In addition, they are difficult to kill.

The team successfully isolated the breast cancer stem cells, coaxing them to multiply in a lab. They then tested 16,000 chemical compounds on them - identifying 32 that effectively killed them.

"It wasn't clear it would be possible to find compounds that selectively kill cancer stem cells," Gupta said in a statement, according to Reuters. "That's what we did."
"A chemical called salinomycin hit the target. It was 100 times more potent at killing breast cancer stem cells than Bristol-Myers Squibb Co's cancer drug Taxol, or paclitaxel," Reuters reported. "Cancer stem cells treated with salinomycin were far less able to start breast cancers when injected into mice than cancer stem cells treated by paclitaxel. And the treatment also appeared to slow the growth of tumors in the mice."

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Breast Pain: How To Deal With It?

Breast pain (mastalgia) is one of the common medical complaints among women. A large number of women experience this at some stage in their lives even though the gravity varies from person to person. It often triggers the fear of cancer. So, it is very much essential for you to understand the following facts about this medical condition.

Types Of Breast Pain:

Mastalgia is of two types; cyclical and noncyclical. The cyclical pain occurs during your menstrual cycles because of the changes in the levels of estrogen and progesterone hormones. It can start a few days before the menstruation and ends when the cycle is over. This may last for years, but normally ends after your menopause.

The non-cyclical one is not related to your menstrual cycle. It is mostly felt in a specific area. This can be the result of a biopsy, but mostly not a sign of cancer. There is another type called costochondritis, which does not occur in your mammaries; but feels so. The reason can be aging or poor posture.

These Are The Causes:

You could experience soreness in your breasts due to any of the following reasons:

* Hormonal changes and water retention during the menstrual cycle * Any injury on or near the chest area * Pregnancy * Infection * Breastfeeding * Use of oral contraceptive pills * Weight gain * Wearing ill-fitting bra * Tumors

Identify The Symptoms:

If your breast pain is cyclical, it is usually felt on both the sides and can leave you feeling heavy on the chest. It starts two weeks before your period, and will increase till the start of the period and then subside. And if you feel a burning and sharp ache, limited to only one side, it is noncyclical. For both, see whether you have nipple discharges, indications of infection like pus, redness, or fever, and any lump.

How To Diagnose?

As per your description of the situation, your doctor will decide whether you need any treatment or not. If your age is less than 35 and you don't have a lump, then a medical test or examination is not recommended. But, even if you don't have a swelling, and are above 35 years of age, you may need to go in for a mammogram once every year.

What Is The Treatment?

The treatment varies according to the causes. Some possible treatments include using a support bra, taking medicines, and using danazol for severe ache. You can also try some natural methods such as:

* Avoiding excessive intake of caffeine * Using less salt * Taking vitamin E or vitamin B6 * Taking a "water-pill" (a diuretic) * Maintaining an ideal weight * Wearing a comfortable bra * Reducing the anxiety levels, and * Sitting in a proper posture while breastfeeding.

It is very important that you analyze the nature of your breast pain and consult a medical practitioner at the earliest to avoid further complications.

by : Andrew Stratton
Source : www.amazines.com

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New Drug for Hard-to-Treat Breast Cancer

An experimental class of drugs may have potential for the treatment of two types of breast cancer that are notoriously difficult to treat.

Called PARP inhibitors, the drugs block the ability of damaged cells to repair themselves, causing cancer cells to die off or become more susceptible to chemotherapy drugs.

One PARP inhibitor, dubbed BSI-201, improved survival by 60% when added to standard chemotherapy drugs in women with so-called triple-negative breast cancer. Such tumors are hard to treat because they lack receptors for the hormones estrogen and progesterone as well as the protein HER2, which are targeted by current therapies.

The other PARP inhibitor, known as olaparib, shrank tumors in nearly half of women with cancer caused by mutations in the BRCA1 and BRCA2 genes. These inherited breast tumors often strike young women and are particularly aggressive.

"While preliminary, these are some of most exciting results we've seen in a long time," says Eric P. Winer, MD, director of the breast oncology center at the Dana-Farber Cancer Institute.

Winer, who wasn't involved with the work, moderated a news conference to discuss the findings at the annual meeting of the American Society of Clinical Oncology.

How PARP Inhibitors Work

PARP is short for poly (ADP-ribose) polymerase, an enzyme used by cancer cells to repair DNA damage.

All cells, cancerous and healthy alike, have multiple systems for DNA repair. Even if one pathway is turned off, most cells can survive.

Researchers are using PARP inhibitors to target tumors where one pathway is already shut down due to damage caused by genetic mutations or chemotherapy. Women with BRCA1/BRCA2 mutations lose a form of DNA repair and thus rely more heavily on the PARP pathway. Chemotherapy drugs damage the ability of cancer cells to repair DNA damage.

By blocking PARP in the already compromised tumor cells, the PARP inhibitors push the cells over the edge.

"There's DNA catastrophe, and tumors shrink," says Andrew Tutt, MD, PhD, director of the Breakthrough Breast Cancer Research Unit at Kings College in London and head of the olaparib study.

The first study involved 116 women with triple-negative breast cancer whose disease had spread to other parts of the body. These women, who account for 15% to 20% of breast cancer patients, have a very aggressive form of the disease for which chemotherapy is the only available therapy, says researcher Joyce O'Shaughnessy, MD, co-director of the Breast Cancer Research Program at Baylor-Charles A. Sammons Cancer Center in Dallas.

The women were randomly assigned to receive standard chemotherapy plus BSI-201, or standard chemo alone.

Women who received BSI-201 lived a median of 9.2 months, compared with 5.7 months for the chemotherapy-only group. Tumors shrank in 48% of patients treated with the PARP inhibitor, compared with 16% of patients on chemotherapy alone.

The new drug was well tolerated, with minimal side effects.

BiPar Sciences Inc., which makes the drug and funded the work, plans to launch a larger study this summer.

In the second study, 54 women with breast cancer that was deficient in BRCA1 or BRCA2 and that persisted despite several rounds of standard chemotherapy were given one of two doses of olaparib. Olaparib is given in pill form, while BSI-201 is injected.

Tumors shrank in 41% of those given the higher dose. The most common side effects were low-grade fatigue and nausea.

Drugmaker AstraZeneca, which funded the work, is in the process of designing a larger study, according to a company spokesperson.

More research is needed, all agree. But if the positive results hold up in future studies, PARP inhibitors will "be a real advance" for women with aggressive, hard-to-treat breast tumors, Winer says.

Source : www.webmd.com

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Vulcan-Backed BiPar Wows Scientists, Helps Women with Breast Cancer Live Longer

Billionaire Paul Allen made windfall profits from his investment in BiPar Sciences, and today we can really see why. The Brisbane, CA-based biotech company founded by Allen’s Vulcan investment firm said today that its drug candidate for women with an aggressive form of breast cancer was able to help them live longer without adding side effects to standard chemotherapy.

Women who were randomly assigned to get the BiPar drug, BSI-201, in combination with chemotherapy lived a median time of 9.2 months, compared with 5.7 months for those who just got the chemo, gemcitabine and carboplatin, researchers said today at the American Society of Clinical Oncology meeting in Orlando, FL. The trial of 116 women also demonstrated BiPar’s treatment shrank or stabilized tumors, and slowed the spread of malignancy, researchers said today in a plenary presentation at the conference, which has attracted 30,000 cancer specialists.
These impressive results were what prompted Paris-based Sanofi-Aventis to pay $500 million to acquire BiPar last month, in a deal that gave Allen a $100 million return on $13 million he has invested since 2005.

The findings will also surely trigger new scientific interest in BiPar’s unusual method of action, in which it aims to block an enzyme called PARP. This enzyme is thought to help cancer cells repair their own DNA after it’s been hammered by chemotherapy. That means a drug that blocks PARP ought to make chemotherapy work better, and reduce relapses. It also could lead to an important new treatment option for about one out of every five breast cancer patients with a tough-to-treat form known as the “triple negative” variety, which means their disease has spread, and they can’t be helped by hormone blockers or Genentech’s trastuzumab (Herceptin). About 194,000 women are diagnosed with breast cancer in the U.S. each year, according to the American Cancer Society.

This result is so impressive that Powel Brown, a cancer prevention researcher at the Baylor College of Medicine, told Bloomberg News that BiPar’s drug is “the biggest story in breast cancer, by far, and it’s going to be a huge bombshell.” The result is so positive, he predicted the drug would be FDA approved in a year or two.

Based on the results, BiPar and Sanofi-Aventis plan to start a pivotal clinical trial this summer to provide more evidence supporting the drug’s effect in this same patient population.

About 62 percent of patients had some clinical benefit when they got the BiPar treatment, which researchers defined as complete or partial tumor shrinkage, or stable tumors for at least six months. Only 21 percent did that well in the control group. When expressed through an important statistical measure known as the hazard ratio, women on the BiPar drug had a 65 percent lower risk of dying than those who didn’t get it. The p-value for this finding was 0.0005, which means there was a 5 in 10,000 possibility that this result was due to chance, or a fluke, which is far greater confidence than the FDA needs to see to approve a new drug.

The most common side effects were neutropenia—a depletion of infection-fighting white blood cells—but there were actually more cases of that in the control group than among those who got the BiPar treatment.

It will be interesting to see what the opinion-makers at ASCO, and the regulators at FDA have to say about these results. Inhibiting PARP is thought to be useful in a number of different cancers, so this could lead to aggressive new investment in the field across the pharma and biotech industry. Nine days ago, when I previewed the importance of this BiPar trial, Vulcan consultant Michael Kranda suggested that a small number of thought leaders who saw the data before today were bowled over by what they saw.

“This is potentially a fundamental advance against solid tumors,” said Kranda, who pulled together the founding syndicate of venture investors in BiPar. “When you talk to the leading companies and the leading doctors in this space, we’re seeing them compare the impact of this to (Novartis’ Gleevec). That drug obliterates tumors, and you don’t see many drugs get mentioned in conversation like that.”

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New Insights, Inroads Against Breast, Ovarian Cancers

"It's nice to be here. It's nice to be anywhere," singer and actress Olivia Newton-John, a self-described 17-year breast cancer "thriver," told reporters at one of the world's largest gatherings of cancer specialists on Sunday.

Newton-John, 60, spoke at a special news briefing on advances and insights in breast and gynecologic cancers, part of the American Society of Clinical Oncology (ASCO) annual meeting in Orlando, Fla.

"I'm very excited about what is going on in the world of cancer treatment," she said. "I feel so fortunate that I can spread the message to other women by saying 'Here I am, 17 years later.'"

But as with every such gathering, researchers delivered both good news and bad news in the war against cancer.

On the bad news front, one study presented at the briefing found that use of the CA125 biomarker to track ovarian cancer did not help guide treatment decisions for women.

Ovarian cancer remains one of the most deadly malignancies primarily because it is typically spotted too late for treatment to be effective. Recently, however, some doctors have turned to blood levels of a molecule called CA125 to screen for the presence of disease, with repeat screens after treatment to gauge the likelihood of a recurrence.

But the new study found that even when CA125 indicated the possibility of cancer relapse and spread, starting additional treatment early did not enhance a woman's survival versus waiting longer for second-line treatment.

For this study, 265 women whose ovarian cancer was in remission after one round of chemotherapy began a second round of chemo as soon as their CA125 levels started to rise. Another 264 women waited until actual signs of a relapse appeared until they began second-line therapy.

This meant that, "patients who were in the early treatment arm started their second-line chemotherapy (based on rising CA125 levels) 4.8 months earlier than those who had waited till signs and symptoms," study author Dr. Gordon Rustin, a professor of oncology at Mount Vernon Cancer Center in Hertfordshire, U.K. , told reporters.

But average overall survival was the same, whether treatment had been guided by CA125 levels or not: 41 months from the completion of the first course of therapy.

"Even more interestingly, the time to third-line therapy was 4.6 months earlier in the earlier-on group," he added. "This indicated that the early initiation of chemotherapy did not induce a longer remission and, despite all this early treatment, did not improve survival."

On the plus side, the findings suggest that rising CA125 levels may not be as dire a marker as once thought, according to the researchers. "For the first time, women can be reassured that there's no benefit from early detection from routine CA125 and they can be told that even if CA125 rises, chemotherapy can be safely delayed until they have signs or symptoms of recurrence," Rustin said. "For the first time ever, women now have informed choices to be able to decide [on testing]. Most of my patients, when given this information, do not want routine CA125 measurements."

The study strikes yet another blow to the notion that CA125 might be the reliable ovarian cancer test everyone is looking for. For example, research published in the April issue of Obstetrics & Gynecology found that combining the CA125 test with transvaginal ultrasound did not help detect ovarian cancer.

The new results may only reinforce that skepticism. "We've put that one [CA125 screening] in the grave so many times it has a zombie-like existence," said Dr. Kelly Marcom, a breast oncologist with Duke Comprehensive Cancer Center and director of the Duke Hereditary Cancer Clinic in Durham, N.C. Still, "I doubt every treating oncologist will stop using this to follow treatment."

Another oncologist agreed. "This study suggests that early detection of metastatic cancer did not improve survival," said Dr. Claudine Isaacs, a medical oncologist with Georgetown's Lombardi Comprehensive Cancer Center in Washington, D.C. Unfortunately, the usefulness of CA125 in initial cervical cancer screening remains "questionable."

But there was good news at the meeting for women battling tough-to-treat breast cancers.

Two new studies found promising results with an entirely new class of drugs, called PARP inhibitors -- the first targeted therapy for so-called "triple-negative" breast cancer. Currently, the 15 percent of breast cancer patients who have this type of aggressive tumor have only the option of surgery and chemotherapy.

Breast cancers associated with the BRCA1 and BRCA 2 gene mutations (which heighten risk) are almost always triple negative, explained Dr. Joyce O'Shaughnessy, lead author of one of the studies and co-director of the Breast Cancer Research Program at Baylor-Charles A. Sammons Cancer Center in Dallas.

About 30 percent of women with triple negative cancer experience a recurrence and, once that happens, only survive a year or so.

In this phase II trial, half of the 120 women with this form of metastatic breast cancer were randomized to receive chemo alone, the other half to chemo plus the PARP inhibitor BSI-201.

Those receiving the combination therapy saw almost a doubling of their survival -- from 5.7 months with chemo alone to 9.2 months when BSI-201 was added in, as well as about a 60 percent reduction in the risk of dying from the disease. There were also no additional side effects as compared with standard chemo.

The second phase II PARP inhibitor trial involved 54 women with advance breast cancer who carried the BRCA1/2 mutations. In this trial, the inhibitors -- especially at the higher of two doses -- succeeded in targeting the weakness in the genes' DNA repair mechanism without affecting healthy cells. Forty-one percent of patients saw their tumors completely disappear, said a British team from Kings College, London. There was a slightly lower response rate in the lower-dose group. Mild nausea and fatigue were the most common side effects.

"The drugs are given orally and it still remains a question as to whether the drugs' benefits will extend beyond this narrow patient population," noted Dr. Eric Weiner, head of ASCO's communication committee and chief of women's cancers at the Dana Farber Cancer Institute in Boston.

"These two studies are very exciting," Marcom said. "It speaks to a really clever understanding of the biology of the cancer."

Two other studies presented at ASCO could represent advances in the treatment of cervical cancer. In one study, led by Dr. Alfonso Duenas-Gonzalez of Mexico's National Cancer Institute, researchers found that adding the chemotherapy drug gemcitabine (Gemzar) to standard chemo and radiation therapy improved both progression-free and overall survival -- but not without notable side effects.

And for women diagnosed with early-stage cervical cancer, the more specific and less invasive prognostic indicator called sentinel-nose biopsy appears just as effective as removal of lymph nodes in the pelvis, according to French researchers at George Pompidou European Hospital, Paris. According to the researchers, opting for biopsy rather than lymph node removal should make tracking the disease much less onerous for patients.

Source : www.forbes.com

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New drug olaparib offers hope to women with genetic breast cancer

A new drug for genetic breast cancer could help thousands of women with hereditary forms of the disease, the first tests on patients suggest.

A study involving 54 women with advanced genetic breast cancer found that the drug olaparib could stop the growth of tumours, and shrink them in more than 40 per cent of cases.

In one case, a woman’s tumour disappeared completely after treatment with the drug, according to results to be presented at a science conference today.

About 5 per cent of the 46,000 cases of breast cancer in Britain each year are caused by defects on the BRCA-1 and BRCA-2 genes, which put women at much higher risk of developing aggressive cancers of the breast or ovaries.

Many women who test positive for the mutations have their breasts removed as a precaution, as they have an 80 per cent risk of developing breast cancer in their lifetime.

Olaparib, made by AstraZeneca , is the first of a new class of drugs specifically designed to treat BRCA-related cancers to be tested on patients. If further tests are successful, they could be used at an early stage to treat or prevent disease occurring within affected families, scientists say.

Pharmaceutical companies are also due to present targeted therapies for cancers of the lung, stomach and ovaries this week at the American Society of Clinical Oncology conference in Orlando, Florida, the world’s largest gathering of cancer scientists.

Andrew Tutt, director of the Breakthrough Breast Cancer Research Unit at King’s College London, who led the trial, said that the results for olaparib were “very promising”.

“We are hopeful that olaparib could provide a targeted treatment for women with BRCA-related breast cancer,” he said. “Some women also develop breast cancer before they know they are carrying the gene, or see it recur if they have been diagnosed previously.”

Charlotte Sword, 40, has had breast cancer diagnosed twice, because of the potentially deadly mutation to the BRCA-1 gene which runs in her family. Her younger sister Audrey has suffered it three times. Both women have had double mastectomies and their ovaries removed.

“Breast cancer has left a horrific mark on our family due to a mutation being passed down the paternal line”, Mrs Sword said yesterday. “I have three nieces who could benefit from this treatment, and could be spared the dreadful illness and side-effects of treatment that my sister and I had to go through.”

Olaparib works by blocking a protein that makes cancer cells which have a BRCA fault unable to repair their own DNNA. This causes the cancer cell to die and means that the tumour should either stop growing or get smaller.

Because the drug works in a targeted way, it kills cancer cells while leaving healthy cells alone in a way that chemotherapy does not, which could help to reduce the punishing side-effects of cancer treatment.

In the study carried out at hospitals in Britain, Europe, the US and Australia, 27 patients took 100mg oral doses of olaparib while another 27 took 400mg doses. More than 40 per cent of tumours in the higher dose group reduced significantly in size, while all tumours were prevented from progressing for an average of six months.

The Times reported this year that the London community of Ashkenazi Jews is being offered screening for BRCA genes that raise risks of breast, ovarian and prostate cancers. Ashkenazi have a high incidence of BRCA-related breast cancer.

The NHS currently offers BRCA testing, but only for women whose relatives have had cancer because of the mutations. But up to 50 per cent of people with the faulty genes do not have a family history of the diseases, largely because the gene can be carried by men.

Dr Tutt said that orlaparib may also have potential as an early-stage or preventative treatment. He added: “It is important to remember this drug is at a very early stage of development.” Herbie Newell, Cancer Research UK scientist at the Northern Research Institute, Newcastle University, said he was “extremely encouraged” by the study’s results.

He said: “Olaparib is one of a family of targeted therapies currently in clinical trials and Cancer Research UK expect that this new class of anti-cancer treatments will make a significant impact in the fight against cancer."

In the family

8% Proportion of cases of breast cancer in women thought to be triggered by genetic factors, although many of the exact causes remain a mystery

2,000 Number of breast cancer cases a year (5 per cent of the total) known to be caused by changes in either the BRCA-1 or BRCA-2 genes that were the first to be associated with a much higher risk of developing breast cancer

1 in 800 Proportion of women in whom a faulty BRCA-1 gene is present. One in 500 carries a faulty copy of the BRCA-2 gene

50-80% Chances of a woman with these genes of getting breast cancer in their lifetime, up to seven times higher than those who do not carry the mutations. They also have a 60 per cent increased risk of ovarian cancer

Source : www.timesonline.co.uk

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Drug combos may raise breast cancer risk

Breast cancer survivors risk having their disease come back if they use certain antidepressants while also taking the cancer prevention drug tamoxifen, worrisome new research shows.

About 500,000 women in the United States take tamoxifen, which cuts in half the chances of a breast cancer recurrence. Many of them also take antidepressants for hot flashes, because hormone pills aren't considered safe after breast cancer.

Doctors have long known that some antidepressants and other medicines can lower the amount of tamoxifen's active form in the bloodstream. But whether this affects cancer risk is unknown.

The new study, reported Saturday at a cancer conference in Florida, is the largest to look at the issue. It found that using these interfering drugs — including Prozac, Paxil or Zoloft — can virtually wipe out the benefit tamoxifen provides.

Many doctors question the magnitude of harm from combining these medicines, and a second, smaller study suggests it may not be very large.

But the bottom line is the same: Not all antidepressants pose this problem, and women should talk to their doctors about which ones are best.

"There are other alternatives we can consider" that are safer, said Dr. Eric Winer, breast cancer chief at the Dana-Farber Cancer Center in Boston.

He had no role in the study, which was done by Medco Health Solutions Inc., a large insurance benefits manager. Researchers used members' medical records to identify 353 women taking tamoxifen plus other drugs that might interfere with it, and 945 women taking tamoxifen alone. Those taking a drug combo did so for about a year on average.

Next, researchers checked to see how many were treated for second cancers in the following two years. Breast cancer recurred in about 7 percent of women on tamoxifen alone, and in 14 percent of women also taking other drugs that could interfere — mainly the antidepressants Paxil and Prozac, and, to a lesser extent, Zoloft.

If women want to take an antidepressant, "you probably want to stay away from those three," said Medco's chief medical officer, Dr. Robert Epstein.

No greater breast cancer risk was seen in women taking the antidepressants Celexa, Lexapro or Luvox with tamoxifen, and there are reasons to think that other antidepressants may be safe as well, Epstein said.

A second study led by Dr. Vincent Dezentjé of Leiden University Medical Center in the Netherlands found little risk from combining tamoxifen and popular antidepressants. However, only 150 women in the study took such combos for more than two months, and they were compared to women taking combos for a shorter time — not to women using tamoxifen alone.

The Dutch and Medco studies were presented at a meeting of the American Society of Clinical Oncology.

The federal Food and Drug Administration has been considering a change to tamoxifen's label to warn about the antidepressants drugs and a gene variation some women have that can make tamoxifen less effective. An advisory panel unanimously recommended a change in 2006, but the agency is still considering it.

"This is a very controversial area," said Dr. Claudine Isaacs, a breast specialist at Georgetown University's Lombardi Comprehensive Cancer Center. "Until these data are absolutely clear, I would avoid drugs that impact on tamoxifen metabolism."

Breast cancer is the most common major cancer in American women. More than 182,000 new cases were diagnosed last year, and it caused nearly 41,000 deaths.

Source : www.wrdw.com

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Drug May Extend Life When Breast Cancer Spreads

A new study affirms that the chemotherapy drug Abraxane is more effective, with less troublesome side effects, than the current drug of choice for metastatic breast cancer.

When compared with Taxotere, Abraxane extended the time before a recurrence by almost seven months, effectively doubling survival. Both are members of a class of drugs known as taxanes.

The study, which was a phase 2 trial, was funded by Abraxis BioScience, which makes Abraxane. The findings are reported in the May 26 issue of the Journal of Clinical Oncology.

“This data, which has been presented at national meetings, reaffirms that Abraxane is a very active drug, is well-tolerated and appears to have a greater anti-tumor effect than what you would see with what had been presumed to be the most active drug,” said Dr. William Gradishar, director of breast medical oncology at the Robert H. Lurie Comprehensive Cancer Center at Northwestern University. “This probably will encourage people to either use or try Abraxane, as opposed to other taxanes.”

Another expert agreed.

“This is a major advance. It’s a very well-tolerated drug and has low toxicity. We’ve used this regimen for a number of years now and it’s very good,” said Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge. “We’re now beginning to realize that many drugs given more frequently at lower doses is not only less toxic but has less side effects. It still doesn’t cure people but it’s a kinder, gentler way of delivering drugs, although it is more expensive.”

Abraxane (nab-paclitaxel) was approved for use in the United States in 2005.

“There has been sort of a preconceived notion that Taxotere is the most potent anti-cancer therapy for metastatic breast cancer, certainly among taxanes,” Gradishar said. “That’s why this comparison was being made.” Gradishar, who was the lead author for the study, is also a consultant to Abraxis BioScience.

The chemotherapy drugs docetaxel, marketed as Taxotere, and paclitaxel are considered the gold standard for treating breast cancer that has spread to other parts of the body.

Abraxane, which is a variant of paclitaxel, uses a different, solvent-free “delivery” system to get the drug into the body.

For the study, 302 women who had not previously been treated for advanced breast cancer were randomized into one of four treatment arms. Three of the four groups were given Abraxane, administered one of three ways: every three weeks, weekly at a lower dose for three weeks with the fourth week off, or weekly at a higher dose for three weeks with the fourth week off. The fourth group was given Taxotere every three weeks at the standard dose.

Abraxane was found to be generally superior to Taxotere in response rates, but the most striking results were seen when the drug was given on a weekly schedule with the fourth week off.

“The anti-tumor effect was greater, and this is how the drug is very commonly used in practice today, although it’s approved as an every-three-week drug,” Gradishar said. “That also translated into a longer time until the disease progressed.”

Abraxane also had fewer side effects than Taxotere, the researchers found. All-in-all, the authors stated, the results suggest that Abraxane may be a preferable first choice for treating this group of patients.

A phase 3 trial comparing the same set of drug regimens is being planned.

One expert noted that the weekly regimen appeared the best.

“This is slightly disappointing in that the every-three-weeks schedule was not as good. That’s more convenient for patients,” said Dr. Jennifer Eng-Wong, an assistant professor of oncology at Georgetown’s Lombardi Comprehensive Cancer Center in Washington, D.C. “But it doesn’t look like it’s the right way to go.”

Source : news.health.com

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Breast Cancer Prevention

With 49 000 new cases and 11 000 deaths per year, breast cancer has experienced a doubling of cases during the past 25 years. And yet, we can prevent this cancer by some simple habits. The risk of breast cancer may be lowered, so play your part!

Just like it is for lung cancer, the causes of breat cancer are easily identified, Only recently a number of these factors have been formally recognized by the light of specific studies. So lets take a look at what you can to to prevent breast vancer and live a healthy life.

Eat less and better.

Again, food is central to the prevention of cardiovascular and neurodegenerative diseases, but also breast cancer, Food is also responsible in the occurrence of a second cancer. Regardless of overweight, trans fats (pastries, pizza, etc.) are increasing by more than double the risk of breast cancer. If it adds an overweight (especially in case of breakdown "android" fat, in short a big belly), the fatty tissue acts like a gland secretory estrogen promoters of cancer, especially after menopause.

Keep Moving!

Thirty minutes of real physical activity (not just vacuuming and ironing!)
would reduce the risk of breast cancer by 30 to 40%. Keeping your body in shape is one of the best weapon against all form of cancers. It may be difficult at first to get out and doing some physical activities but the rewards are fantastic. A simple bicycle ride every day is enough to stay in shape. So let's move!

Drink less than one glass of alcohol per day.

Once the equivalent of 10 grams (one glass), the rate of circulating hormones (estrogen always) grows, as does the risk of tumor growth, especially breast. The risk increase by 9% every 10 grams of alcohol ingested. Alcool is one of the worst enemy for pregnant women.

Make your first baby around 25 years old.

This factor is the "heavy" in terms of risk ... At least 20% of cancers would be redundant due to the increasingly late age of the first full-term pregnancy, which is nearly 30 years today.

Nurse your baby ideally for 6 months.

The risk decreases with the number of children and especially if they were breastfed: endogène secretion of estrogen are dropping considerably during pregnancy and weaning.

Protect yourself against xenoestrogens.

A xenophobic estrogen is a chemical compound, which is recognized by a living organism as an estrogen.

You must especially avoid periods where your body is changing and more vulnerable to hormonal changes, ie when you are pregnant of a baby girl (for him to avoid breast cancer later.

Breast cancer accounts for one third of new cancers in women. If it is detected early, it is better supported. Women with breast cancer benefit from treatment tailored to their pathology. Four technologies are mainly used. In order of importance: surgery, radiotherapy, chemotherapy and hormone therapy. Since the year 2000 medical advance has been made on all fronts in the fight against breast cancer. Early detection and treatment are essential to defeat the disease.

Good Luck!

Authors : Florida Abortions Clinic. Dr. James S. Pendergraft opened the Orlando Women's Center ..

Source : www.articlesbase.com

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Chemotherapy Superior to New Drug for Early Breast Cancer

Older women with early-stage breast cancer do better after standard chemotherapy than they do with the oral drug capecitabine (Xeloda), a new study finds.

"After three years, 85 percent of people who received chemotherapy were doing well, and 68 percent of people who received capecitabine were doing well," said lead researcher Dr. Hyman Muss, a professor of medicine at the University of North Carolina at Chapel Hill.

"In this trial, we had hoped that it [capecitabine] would be as good as standard therapy, so we would have a pill treatment with less side effects, but it turned out it wasn't as good," Muss said.

The report is published in the May 14 issue of the New England Journal of Medicine.

Because it has fewer side effects, capecitabine has been approved by the U.S. Food and Drug Administration for use in patients with advanced breast and colon cancer. Used in this context, it improves quality of life and may extend life for several months, the researchers said.

For the study, Muss and colleagues randomly assigned 600 women aged 65 and older with early-stage breast cancer to standard treatment with a combination of chemotherapy drugs or capecitabine.

Women taking capecitabine were roughly twice as likely to have a relapse of their cancer or die, the researchers found. Three years after treatment, 85 percent of women who received standard chemotherapy were alive and cancer-free compared with 68 percent of the women who received capecitabine, the team found.

The greatest benefit of chemotherapy was among the minority of women with hormone receptor-negative breast cancer, Muss said.

However, in women whose cancer is hormone receptor-positive, "we showed that standard therapy and capecitabine were pretty similar," Muss said. "It would be reasonable for these women to select capecitabine over standard chemotherapy, but my bias would still be to pick the standard right now."

Other studies with women younger than 70 have also found standard chemotherapy provided better outcomes than a single drug, the researchers noted.

Dr. Nancy Davidson, director of the University of Pittsburgh Cancer Institute, thinks that the results of this study confirm the benefit of chemotherapy for treating women with early-stage breast cancer.

"This is a critical trial for two reasons," Davidson said. "It demonstrates that properly selected older women, who comprise the vast majority of patients with breast cancer, can benefit from state of the art chemotherapy just as younger women do. Thus, age alone should not be a reason to withhold chemotherapy," she said.

"It also demonstrates, yet again, that multi-agent chemotherapy gives better results than single agent chemotherapy for early breast cancer," Davidson said. "This trial does not say that capecitabine is an inactive drug -- rather its routine use should be limited to women with advanced breast cancer where it is used quite successfully as a way to minimize symptoms of disease. It is also very useful in other cancers like colon cancer."

Barbara A. Brenner, executive director of Breast Cancer Action, thinks most women like those in the study should opt for standard chemotherapy.

"The premise is always, if there is something new, let's do it, it will be better, and this actually shows that this is not the case," Brenner said.

Brenner doesn't think women should choose capecitabine even though its benefit is close to chemotherapy in some women. "Close, but not close enough," she said.

In selecting a breast cancer treatment, women should ask their doctor about their chance of relapse, Brenner stressed. "Make your best informed decision," she said.

Source : www.forbes.com

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Trial of new combination treatment targeting hormone receptor-positive locally advanced breast cancer

Researchers at The Cancer Institute of New Jersey (CINJ) have opened a clinical trial, which aims to evaluate a new treatment for breast cancer in combination with one that is already approved for other types of cancers.

The new combination is targeted toward treatment of hormone receptor-positive locally advanced cancer (cancer cells that grow and multiply when the estrogen hormone attaches to the hormone receptor) or metastatic breast cancer (cancer that spreads to other parts of the body). CINJ is a center of excellence of UMDNJ-Robert Wood Johnson Medical School.

According to the American Cancer Society, excluding skin cancer, breast cancer is the most frequently diagnosed cancer in women. In 2008, it was estimated that more than 182,000 women were diagnosed with breast cancer in the United States, while more than 40,000 died from the disease. In New Jersey, there were 6,300 new cases with approximately 1,400 deaths. That is why CINJ investigators are testing the effectiveness of the drug sorafenib in combination with letrozole.

Sorafenib is an approved medication by the U.S. Food and Drug Administration (FDA) used to treat certain advanced kidney cancers and liver cancer. It fights the disease by interfering with the ability of cancer cells to grow and divide. There have been studies performed with this drug by itself in patients with metastatic breast cancer, with results showing only a small effect on the tumor.

But according to Antoinette Tan, MD, a medical oncologist at CINJ and assistant professor of medicine at UMNDJ-Robert Wood Johnson Medical School, there is a lot of potential for sorafenib to be combined with letrozole, a drug which blocks enzymes that make the estrogen hormone. Letrozole received FDA approval in 2001 for the treatment of patients with metastatic breast cancer. It has been shown to be more effective than the drug tamoxifen, which is commonly used for treatment, and to have fewer side effects than other medications used in hormonal therapy. Dr. Tan is the lead researcher on the new study.

Selected patients will take letrozole and sorafenib by mouth and keep a pill diary for 28 days. At 12 weeks, patients will undergo tests like a CT scan or MRI, which look at the organs in the body, to check on the combined effect on the tumor. The aforementioned drugs for the study will be supplied by Bayer Pharmaceuticals and Novartis Pharmaceuticals.

Women over age 18, who are post-menopausal and have the diagnosis of hormone receptor-positive locally advanced or metastatic breast cancer are eligible to take part in the trial, although other criteria must be met. The study is part of the CINJ Oncology Group (CINJOG), which is comprised of physicians throughout New Jersey from the CINJ Network of hospitals. For additional information on how to participate, individuals should call 732-235-7251.

Clinical trials, often called cancer research studies, test new treatments and new ways of using existing treatments for cancer. At CINJ, researchers use these studies to answer questions about how a treatment affects the human body and to make sure it is safe and effective. There are several types of clinical trials that are currently underway at CINJ, including those that diagnose, treat, prevent, and manage symptoms of cancer. Many treatments used today, whether it is drugs or vaccines; ways to do surgery or give radiation therapy; or combinations of treatments, are the results of past clinical trials.

As New Jersey's only National Cancer Institute-designated Comprehensive Cancer Center, CINJ offers patients access to treatment options not available at other institutions within the state. CINJ currently enrolls more than 1,000 patients on clinical trials, including approximately 15 percent of all new adult cancer patients and approximately 70 percent of all pediatric cancer patients. Enrollment in these studies nationwide is fewer than five percent of all adult cancer patients.

Source : www.news-medical.net

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