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Breast Cancer News--some Very Interesting Things Here

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UPDATE 1-Study confirms breast cancer pill Arimidex best

Fri Dec 14, 2007 5:34pm EST

Reuters

By Julie Steenhuysen

CHICAGO, Dec 14 (Reuters) - Women who took AstraZeneca Plc's breast cancer drug Arimidex fared better than those who took the pill tamoxifen even four years after they stopped taking it, researchers said on Friday.

Arimidex belongs to a new class of breast cancer drugs known as aromatase inhibitors, which block the production of estrogen that can lead to cancer.

"We did not have any data on what would happen to these patients who were being offered the therapy once therapy stopped -- whether they would would remain alive and free of cancer," said Dr. Aman Buzdar of the University of Texas M.D. Anderson Cancer Center in Houston, who led the U.S. portion of the trial.

The global trial was funded by AstraZeneca in collaboration with academic research centers.

The study, which offers a little more than eight years of follow-up data -- the longest yet -- was published online in the Lancet Oncology medical journal to coincide with its presentation at San Antonio Breast Cancer Symposium.

It suggests treatment benefits extend long after active treatment has ended.

"The data confirm that we are keeping more patients alive without the recurrence of cancer," said Buzdar in a telephone interview from the symposium.

amoxifen transformed breast cancer therapy when it was shown to reduce the risk of cancer coming back by close to 50 percent. But the pill, sold by AstraZeneca (AZN.L: Quote, Profile, Research) under the brand Nolvadex and also sold generically, raises the risk of death from strokes and endometrial cancer.

Dr. John Forbes of the University of Newcastle in New South Wales, Australia, led a team that compared the use of Arimidex, known generically as anastrozole, with tamoxifen in more than 9,000 post-menopausal women with hormone-sensitive early breast cancer that had not spread to other parts of the body.

Earlier results showed that at 5-1/2 years (68 months) of follow up, women treated with Arimidex fared better with significantly fewer side effects than those treated with tamoxifen. One exception is that women on Arimidex did have more bone fractures.

In the latest study, Arimidex continued to keep breast cancer at bay some four years after treatment ended, with fewer women having a recurrence of breast cancer compared with the tamoxifen group.

The study found no significant difference in the risk of heart-related deaths between women treated with Arimidex or tamoxifen. And the increased risk of fractures seen in Arimidex patients did not persist after treatment ended.

"These drugs are definitely superior to tamoxifen. They keep more patients free of cancer and they have a better safety profile compared to tamoxifen," Buzdar said.

The study found no difference in overall survival between the two groups, a finding they said is likely because the average age of the patients was 72 and many of the women died from causes other than breast cancer.

Breast cancer is the second-leading cause of cancer death among U.S. women, after lung cancer. It kills 500,000 people globally every year.

Pfizer Inc (PFE.N: Quote, Profile, Research) also makes an aromatase inhibitor called exemestane, which it sells under the brand name Aromasin, and Novartis (NOVN.VX: Quote, Profile, Research) makes one called letrozole or Femara.

Test may spare many women chemotherapy

By Judy Peres | Tribune staff reporter

December 14, 2007

SAN ANTONIO - A gene test can help doctors determine which breast cancer patients are likely to benefit from chemotherapy, even for those whose tumors are relatively more advanced, researchers reported Thursday.

The finding needs to be confirmed in clinical trials, but experts said the test could already be used to spare some women from the debilitating side effects of cancer drugs.

The research study, among others being presented at the 30th annual San Antonio Breast Cancer Symposium, is part of a trend away from one-size-fits-all medicine.

"Each year we get a little closer" to an individualized treatment of breast cancer, said Dr. Eric Winer of Harvard University. "A few years ago, the vast majority of patients got chemotherapy. Now, more and more are asking whether it's really appropriate."

Breast cancer patients typically are treated with surgery, drugs and radiation, and those with more advanced disease almost always receive chemotherapy. Scientists have known for years that most patients don't benefit from the harsh drugs, but they can't predict who will respond.

Dr. Kathy Albain of Loyola University Medical Center in Maywood presented the findings of a retrospective study in which breast cancer patients were randomly assigned to tamoxifen, a drug that blocks the action of estrogen on breast cells, or to tamoxifen plus a standard chemotherapy regimen. All the patients in the study were "node-positive," meaning the cancer had spread to the lymph nodes under their arms.

A 21-gene test called Oncotype DX was run on paraffin-embedded tumor samples from the patients that had been stored in tissue banks, and the researchers obtained "recurrence scores" for 148 women who had taken only tamoxifen and for 219 who had received chemotherapy as well.

They discovered that patients who scored at the low end of the test range got virtually no benefit from chemotherapy: Ten years after their diagnosis, they were about as likely to suffer a relapse or die as those who had skipped chemotherapy. On the other hand, women with high scores did significantly better on chemotherapy than on tamoxifen alone. And the results held true no matter how old the patients were.

This study "increases our confidence in determining who should avoid chemotherapy despite having positive nodes, and who should get it despite older age," Albain said.

About 180,000 women a year are diagnosed with breast cancer in the U.S., and three-quarters of them have tumors that are fueled by estrogen. Approximately one-third of breast cancer cases have spread to the lymph nodes at the time of diagnosis. That means some 45,000 women a year could potentially benefit from Albain's research.

But Albain noted that even among patients considered at low risk, 40 percent relapsed or died within 10 years.

"We need to learn how to better treat those patients," Albain said. "Maybe it's giving them chemo in a different way. But we know the standard chemotherapy isn't helping."

Source: Chicago Tribune

There was some bad news recently with the FDA rejecting Avastin for breast cancer but on another note the blood test for it has now been launched in the UK

http://news.sky.com/skynews/article/0,,30100-1296988,00.html

I think this test was first reported on in summer 2006.

Hoefully it will become another tool in the armory allowing very early detection to go along with those for prostate, bowel and liver for example

Thanks very much for the information.

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