вторник, 14 июня 2011 г.

Everolimus May Help Thwart Trastuzumab Resistance In Breast Cancer Patients

BERLIN - New data identify a possible role for everolimus in reversing or delaying the onset of trastuzumab resistance in breast cancer patients.


The findings are from two trials presented at the joint 15th European Cancer Organization (ECCO) and 34th European Society for Medical Oncology (ESMO) Multidisciplinary Congress.


Everolimus is an oral mTOR inhibitor that is approved for the treatment of patients with advanced renal cell carcinoma whose disease has progressed on or after treatment with vascular endothelial growth factor-targeted therapy.


The drug has also been shown to reverse trastuzumab resistance caused by PTN loss in preclinical studies and additionally has shown anti-tumor activity as a single agent in patients with metastatic breast cancer.


Dr. Sara Hurvitz, with the UCLA School of Medicine, and colleagues conducted a study to establish the feasible dose schedule for daily and weekly administration of everolimus combined with weekly trastuzumab and paclitaxel in patients with HER-2 overexpressing metastatic breast cancer whose disease had progressed during or after trastuzumab therapy.


Results in 33 patients showed that the combination was well tolerated and that the recommended starting dose for the phase II study is 10 mg daily.


Combination therapy involving everolimus, paclitaxel, and trastuzumab demonstrated "encouraging" efficacy in this heavily treated population of patients refractory to trastuzumab and taxanes. In particular, everolimus demonstrated activity in all patients who were evaluable for efficacy and assigned to the 5 mg everolimus treatment group.


The disease control rate was 85% (28 of 33 evaluable patients).


Biomarker results were similar to those observed during everolimus monotherapy in patients with metastatic renal cell cancer and suggest that the activity of everolimus is mediated in part through inhibition of VEGF-A-driven angiogenesis, Dr. Hurvitz said.


In a second study, similar results were obtained with the combination of everolimus (5 mg daily or 20 or 30 mg weekly) with vinorelbine and trastuzumab.


Dr. Fatima Cardoso, with the Jules Bordet Institute in Brussels, reported that the combination was feasible and tolerable in a similar heavily pretreated group of breast cancer patients and also showed promising clinical activity with a relevant long-term disease control. The disease control rate was 80% (37 of 46 evaluable patients).


In the study, there was no limit to the number of prior antineoplastic treatments.



Overall, 30 patients were assigned to a 5 mg daily dose of everolimus, and 20 patients received a 20 or 30 mg weekly dose.


Dr. Cardoso said that the addition of everolimus can bolster the therapeutic activity of vinorelbine and trastuzumab and reverse or postpone the onset of trastuzumab resistance.


Written by Jill Stein

Jill Stein is a Paris-based freelance medical writer.



понедельник, 13 июня 2011 г.

Clinical Study of Sentinel Breast Scan

Infrared Sciences Corporation (ISC) announced today that they have commenced a Clinical Study with the New York Presbyterian Hospital-Weill Medical College of Cornell University in New York City. The protocol will focus on determining the adjunctive effectiveness of the Infrared Sciences Sentinel BreastScan imaging system for early breast cancer detection. Study patients will have been scheduled for a breast biopsy, either by mammography or ultrasound. The Study will correlate the outcomes of radiology, pathology, and the Sentinel BreastScan.



"We are pleased and excited to commence this study with Cornell, and we believe that the information obtained from the Sentinel system will prove it to be a highly effective adjunctive tool in the war against breast cancer" explained ISC Vice President, Matthew Campisi. "The Sentinel system provides a new physiological dimension to breast health information that is not available from any other fully non-invasive testing method."



Sentinel BreastScan is a painless, touchless, non-invasive procedure offered to women of any age. The technology is based on advanced digital infrared imaging that is combined with sophisticated software employing artificial intelligence techniques. Immediately following the 4-minute test, it provides the doctor with a fully-interpreted, objective report. It is the only system like it in the world.



Sentinel BreastScan is intended to be an adjunctive procedure and does not replace mammography or ultrasound, or stand alone as a single test that can determine overall breast health.



For more information contact Infrared Sciences Corporation., at 213 Hallock Road, Suite 5, Stony Brook, New York, 11790. TEL: 631 240-9106, FAX: 631 240-9108, infoinfraredsciences, or visit infraredsciences.

воскресенье, 12 июня 2011 г.

Follow-Up Study Confirms Link Between Migraines And Reduced Breast Cancer Risk

The relationship between migraine headaches in women and a significant reduction in breast cancer risk has been confirmed in a follow-on study to landmark research published last year and conducted by scientists at Fred Hutchinson Cancer Research Center. The new study found a 26 percent reduced risk of breast cancer among both premenopausal and postmenopausal women with a clinical diagnosis of migraines.



The study appears in the July 2009 issue of Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research. It was led by Christopher I. Li, M.D., Ph.D., a breast-cancer epidemiologist and associate member of the Hutchinson Center's Public Health Sciences Division. Li led the first-of-its-kind study linking migraines with breast cancer risk reduction that was published in the same journal last November.



This time researchers found that the risk reduction remained statistically similar regardless of a woman's menopausal status, her age at migraine diagnosis, use of prescription migraine medications or whether she avoided known migraine "triggers" such as alcohol consumption, smoking and taking hormone replacements. These triggers are also well-established breast cancer risk factors.



Some key differences between this study and the initial one that discovered the link include:
The sample size was more than four times larger this time - more than 4,500 cases and controls versus about 1,000 each in the first study - and was more diverse geographically, drawing women from five metropolitan areas instead of only one. "From an epidemiological perspective, having a larger and more diverse study in its underlying population helps in replicating the finding," Li said.


The age range of women studied was wider this time, 34-64 years of age versus 55-74 years old. "We were able to look at whether this association was seen among both pre-menopausal and post menopausal women," Li said. "In breast cancer this is relevant because there are certain risk factors that are different between older and younger women. In this study we saw the same reduction in breast cancer risk associated with a migraine history regardless of age."


Researchers were able to ascertain whether women in the study had lifestyle behaviors that are known migraine triggers - alcohol consumption, smoking and taking hormone replacement therapy. Researchers posited that perhaps women who had migraines drank and smoked less and didn't take hormone replacements. "But in this study we looked at women who never drank, never smoked and who also didn't use hormones and found the same association within each of those groups, suggesting that the association between migraine and reduced breast cancer risk may be independent of those other factors and may stand alone as a protective factor," he said.

What remains unknown is how migraine confers its apparent protection against breast cancer. "We know that migraine is definitely related to hormones and that's why we started looking at this in the first place," Li said. "We have different ideas about what may be going on but it's unclear exactly what the biological mechanisms are."



In the meantime, research on migraines and breast cancer continues. Li and his colleagues are conducting a follow-up investigation among the women in the first study to determine the types, timing, intensity and severity of their migraines in hopes that the data may elicit additional clues.



And, the research group has submitted a third study for publication that found that the association between migraine and reduced breast cancer risk holds up independent of whether women with migraine took non-steroidal anti-inflammatory drugs such as aspirin and ibuprofen. Earlier studies linked these medications to reduced breast cancer risk as well.



Source:
Dean Forbes


Fred Hutchinson Cancer Research Center

суббота, 11 июня 2011 г.

Possible Negative Effect Of Disadvantaged Neighborhoods On Breast Cancer In Black Women

Researchers at the University of Chicago are studying possible connections between living in disadvantaged neighborhoods and the development of early onset breast cancer in a path-breaking project led by Sarah Gehlert, Director of the Center for Interdisciplinary Health Disparities Research.



The initiative is funded with a $9.7 million grant from National Institutes of Health and is the first to use animal models to help determine what the biological factors might be behind the development of certain forms of breast cancer.



Gehlert is lead author of the paper discussing the findings, titled "Targeting Health Disparities: Linking Upstream Determinants to Downstream Interventions" published in the current issue of Health Affairs.



Joining Gehlert, who is the Helen Ross Professor in the School of Social Service Administration at the University, as an author in the paper is Olufunmilayo Olopade, the Walter L. Palmer Distinguished Service Professor in Medicine and Human Genetics at the University. As part of the work of the CIHDR, Olopade and other scholars studied early onset breast cases in Nigerian women, whose genetic heritage is similar to African-Americans because the ancestors of African Americans largely came from West Africa.



African-American, like Nigerian women, develop breast cancer earlier than white women, and it is often much deadlier. While white women usually develop the disease after menopause, it develops prior to menopause among women of African heritage.



Co-author Martha McClintock, the David Lee Shillinglaw Distinguished Service Professor in Psychology at the University, carried out the animal modeling by studying the development of spontaneous mammary tumors in socially isolated rats.



Researchers are studying 230 black women with newly diagnosed breast cancers living in predominantly black Chicago neighborhoods to learn about environmental factors, such asneighborhood features that might lead to social isolation.



"These women experience stress from dealing with situations they cannot control, from seeing crime in their neighborhood, from being afraid to go out, and not being able to form casual relationships with their neighbors that might make them feel safe," Gehlert said.



By studying multiple pathways to the development of the disease, leading from environmental challenges to gene regulation, the team will help inform policy makers about making decisions in how to create cost-effective interventions, McClintock said.



The team said that the women's vulnerability to stress and social isolation could be reduced if communities work with neighborhood and city leaders to reduce building vacancies and establish networks that would give women a greater feeling of control over their environments.







Other authors in the study are University researchers Dana Sohmer, Tina Sacks and Charles Mininger.



Source: William Harms


University of Chicago

пятница, 10 июня 2011 г.

Enrollment Restrictions For California Breast Cancer Screening Program Lead To Reduced Services

Many California mammography clinics and mobile care units have suspended or reduced services since the state's Every Woman Counts program halted enrollment and raised age eligibility requirements for no-cost breast cancer screenings and diagnostic services, the AP/San Francisco Chronicle reports. The California Department of Public Health imposed a temporary enrollment freeze from Jan. 1 to July 1 to reduce the number of mammogram beneficiaries to 259,000 this fiscal year, from 311,000 last year.

DPH also increased the minimum age for program participants from 40 to 50, mirroring recent U.S. Preventive Services Taskforce guidelines stating that most women should begin screenings at age 50, rather than 40. According to Sean Tuffnell, a public policy expert for the Susan Komen Foundation for the Cure, California is the only state that has adjusted its mammogram eligibility rules since the recommendations were issued.

Several clinics and mobile care units reported drops in patient volume since the program changes. For example, the Elizabeth Center for Cancer Detection in Los Angeles reported a 34% decrease in its patient load during the first three months of 2010. The clinic temporarily closed in April but now offers services three days per week. CEO Don Cook said the clinic faces permanent closure at the end of May.

Mobile Mammography Screening President Deborah Wright said she laid off all of her 40 mammography technicians and suspended service at her 11 mobile units after the program changes. The mobile clinics screened 1,600 patients in January, down from a monthly average of 6,250 patient screenings in 2009.

For fiscal year 2009-2010, Every Woman Counts received $61.3 million in funding, a nearly $10 million increase from the previous fiscal year. However, officials said the funding reflected a one-time budget boost from an unspent tax and did not cover cost increases.

State Sen. Jenny Oropeza (D) has introduced a bill (SB 836) that would reinstate funding for the program. The legislation is before the state Senate Appropriations Committee (Mohajer, AP/San Francisco Chronicle, 5/9).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


© 2010 The Advisory Board Company. All rights reserved.

четверг, 9 июня 2011 г.

Breast Cancer Survival Rates Improved By Novel Drug Sequence, Say Researchers

Changing the way women are treated for breast cancer could improve their overall chance of survival, according to research published today in the Lancet. The new paper shows that switching to a drug called exemestane, two to three years after commencing standard therapy with the drug tamoxifen, can cut the risk of death for certain women by a further 17% compared with using tamoxifen alone.


Postmenopausal women with early-stage hormone-sensitive primary breast cancer are usually treated with tamoxifen for five years, once they are free of disease, to reduce the risk of their cancer recurring. This therapy was once viewed as the 'gold-standard' treatment and it has been shown to cut the risk of death by 34%.


Over recent years, increasing numbers of these women have been receiving treatment with tamoxifen followed by Aromatase Inhibitors such as exemestane.


The Intergroup Exemestane Study (IES), which involved women from 37 different countries, has been examining the benefits of taking tamoxifen for two to three years and then switching to exemestane for the remainder of the five-year period. This new research is the first to show that early benefits of the tamoxifen and exemestane treatment sequence are maintained after treatment has stopped. The study, which was led by researchers from Imperial College London and The Institute of Cancer Research, was funded by Cancer Research UK and Pfizer.


The majority of breast cancer cases are hormone-sensitive, meaning that the cancer cells respond to oestrogen and die when they are deprived of the hormone. Tamoxifen works by preventing oestrogen from acting on cancer cells, whereas exemestane is an Aromatase Inhibitor, which works by stopping the body's production of oestrogen.


The researchers believe that during treatment with tamoxifen, some cancer cells can become resistant to the effects of the drug. Exemestane is subsequently able to kill these resistant cells by withdrawing the oestrogen from circulation.


The researchers examined 2,352 postmenopausal women with early-stage breast cancer who switched to exemestane, compared with another group of 2,372 women who were treated with tamoxifen alone. The women were halfway through their five-year tamoxifen treatment when they joined the study and they were followed up for a median of 56 months after this point.


The study found that the women taking exemestane had a 15% lower risk of dying than those taking only tamoxifen. When women whose tumours were found not to be hormone sensitive were excluded (8% of the total), the improvement increased to 17%.


The results of the study also suggest that sequential use of tamoxifen and exemestane is safe and well tolerated.


Professor Charles Coombes, lead author of the paper from the Cancer Research UK Department of Cancer Medicine at Imperial College London, and based at Hammersmith Hospital, said: "This study shows that, in order to get best results, patients need to be treated with a sequence of anti-hormonal treatments. Just giving one or other drug, such as has been done in some other studies, has not been shown to give added benefit in terms of improved survival. The task now is to determine what other drugs should be given in sequence to prevent cancer cells that have become resistant to exemestane from growing."


Professor Judith Bliss, Director of The Cancer Research UK Clinical Trials and Statistics Unit at The Institute of Cancer Research said: "This trial is an excellent example of how international collaborations between researchers and clinicians can be quickly translated into a cost effective treatment strategy providing patient benefit. To the many postmenopausal breast cancer patients around the world this new research offers the hope of improved treatment options."


Current practice is to give patients treatment for a period of time after surgery and then stop. Following this, doctors wait for a recurrence of the cancer, at which point it is often impossible to cure the disease.


Professor Coombes added: "The other challenge is to find a way of monitoring breast cancer to find a blood test that can tell us when some cancer cells are once more growing. This will allow us to time the sequence of treatment more accurately. A test for early resistance would give us a chance of curing the disease whilst it is still at an early stage."


IMPERIAL COLLEGE UNIVERSITY OF LONDON

Exhibition Road

London

SW7 2AZ

ic.ac.uk

среда, 8 июня 2011 г.

New Guidance To Address Lack Of Support For Employees Affected By Cancer, UK

More than 40 percent of employers do not provide any support or information to employees with cancer, despite the fact that the illness casts its shadow on the vast majority of workplaces, according to new research published today by an alliance of employer groups and a cancer charity.



The research is accompanied by new practical guidance to help employers to manage the estimated 90,000 people of working age who receive a cancer diagnosis each year, and support them during their treatment and recuperation, as well as in their rehabilitation and return-to-work.


Key findings from today's report, produced jointly by the Chartered Institute of Personnel and Development (CIPD), Cancerbackup and the Working with Cancer group, include:


-- Two thirds of employers say they do not provide any training for managers to support employees with cancer


-- More than 40% of employers do not provide any support or information to employees with cancer, and a further 36% of respondents did not know if such information or support was provided


-- More than one in five employers (22%) are not aware that the Disability Discrimination Act now classes cancer as a disability


-- Nearly three-quarters (73%) of employers do not have a formal policy in place for managing employees affected by cancer.


More than half a million people in the UK under the age of 65 have been diagnosed with cancer and many will remain in work during treatment, or seek to return to work after treatment. With new treatments being developed all the time, this figure is likely to increase. The guidance launched today aims to provide employers, human resources and line managers with the tools to ensure that staff feel respected and informed throughout their cancer journey. The guidance includes:


-- First steps - meeting with the employee

-- Returning to work

-- Disability caused by cancer

-- Disability Discrimination act

-- A template cancer policy


The research, based on a survey of 219 employers, employing a total of over 800,000 people, and guidance for employers, was inspired by the Working with Cancer group, a group of leading human resources professionals, all of whom were diagnosed with cancer, who on returning to work were shocked at the lack of support for staff affected by cancer and decided to campaign to raise awareness amongst employers.


Barbara Wilson, spokesperson for the Working with Cancer group and Head of Resourcing and Development at Schroders, said:


"While I was being treated for cancer, I found I was surrounded by booklets to help me cope with the illness and the treatments, how to tell my children and so on. But there was nothing to help me deal with my employers, or to help them deal with me. The guidance we're unveiling today will help employers to understand how to manage employees working with cancer, to provide appropriate information and support to their colleagues, and to help the employee with cancer keep working or return successfully to work after treatment."


Ben Willmott, Employee Relations Adviser at the CIPD, said:


"Employers that fail to provide support and advice to those diagnosed with cancer run the risk of losing talented and experienced employees who would otherwise continue to make a contribution to the organisation. At the extreme, employers could also find that insufficient support and unsympathetic attitudes leave them open to claims under the DDA - a fact that our survey shows one in five employers are unaware of."


"Cancer can be both physically and emotionally extremely draining, which is why it is important that people feel supported by their employers," says Joanne Rule Cancerbackup, Chief Executive. "Cancerbackup's research into people's experience of work and cancer found that many people are not offered any information about their statutory rights by employers nor offered flexible working arrangements to fit around treatment and returning to work. As a result many people don't return to work, even though they want to."


Download Working with Cancer Survey Results (PDF 416.51 Kb)


cancerbackup.uk