San Antonio Breast Cancer Symposium 2005
George Canellos, Dana-Farber Cancer Institute, Boston
Gordon McVie, European Institute of Oncology, Milan
Pat Price, Christie Hospital, Manchester
Gianni Bonadonna, Istituto Nazionale Tumori, Milan
Producer: Derek Thorne
In this edition:
The targeted drug trastuzumab may be used in place of anthracyclines for breast adjuvant chemotherapy regimens, according to the findings of Dennis Slamon, who announced the BCIRG 006 study findings to the San Antonio conference. Norman Wolmark commented.
Kathy Miller gave the Breast Cancer conference early data showing that the anti-vascular endothelial growth factor agent, bevacizumab, has improved survival among patients with metastatic breast cancer.
Dose-dense chemotherapy should be considered mainly in hormone receptor negative breast cancer patients, so said Clifford Hudis, while Martine Piccart warned against over-enthusiasm for cytotoxic chemotherapy among patients who could benefit more from endocrine treatment.
Switching from tamoxifen to anastrozole brought clear benefits according to a meta-analysis presented in San Antonio by Walter Jonat. And ductal carcinoma in situ should be treated with radiation according to Nina Bijker‘s report to the conference.
Dennis Slamon, UCLA School of Medicine, Los Angeles
It may be reasonable to replace the anthracycline component of adjuvant chemotherapy with carboplatin in HER-2 positive patients with early breast cancer – provided agents such as docetaxel and trastuzumab are also included, according to the findings of the BCIRG 006 trial reported at the San Antonio breast cancer symposium.
COMMENT: Norman Wolmark, NSABP foundation, Pittsburg
Richard Gelber, Harvard Medical School, Boston
Latest findings from the HERA study show that Trastuzumab (Herceptin) gave significantly lower rates of local recurrence among patients with breast cancer in whom this targeted agent was added after standard adjuvant therapy.
Edith Perez, Mayo Clinic, Jacksonville
In a study of some 3 000 patients the use of trastuzumab in adjuvant therapy for breast cancer gave significant benefits with acceptable cardiac toxicity.
Kathy Miller, Indiana University School of Medicine, Indianapolis
Adding the anti-vascular endothelial growth factor (VEG-F) inhibitor, bevacizumab, gave a marked improvement of survival among women with recurrent or metastatic breast cancer.
Stephen Jones, US Oncology Research, Houston
Docetaxel did better than doxorubicin when added to cylcophosphamide therapy for patients with early breast cancer.
Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York
Patients with estrogen-receptor negative breast cancer derived some benefit from dose dense schedules of chemotherapy.
Joseph Sparano, Albert Einstein College of Medicine, New York
No difference was found between the benefit of regimens including paclitaxel as compared with docetaxel among patients with early breast cancer receiving adjuvant chemotherapy.
Martine Piccart, Jules Bordet Cancer Institute, Brussels
Adjuvant therapy needs to be individualised for each patient, and the use of cytotoxic chemotherapy may often be avoided in favour of endocrine therapy among patients whose tumours have been shown to be sensitive to hormone modulators.
Ivo Olivotto, University of British Columbia, Victoria
Three decades of cancer statistics show that adjuvant therapy has greatly benefited patients with breast cancer since the 1970s.
Paul Goss, Massachusetts General Hospital, Boston
Post menopausal patients with breast cancer whose endocrine therapy was switched from tamoxifen to letrozole showed a benefit in the NCIC MA17 study among 5 000 women.
Lois Shepherd, Queen’s University, Kingston, Ontario
The NCIC trial of the aromatase inhibitor, letrozole, has also shown that patients whose tumours are positive for both oestrogen and progesterone receptors benefit from letrozole, whereas those with ER positive and PGR negative do less well and could be considered for other therapies after initially receiving 5 years of tamoxifen.
Walter Jonat, University of Kiel
A meta-analysis of patients switching after 2 years from tamoxifen to treatment with aromatase inhibitors (including letrozole and anastrozole) showed benefits over patients remaining on tamoxifen therapy.
Michael Gnant, University of Vienna
Among patient who receive conservative surgery for their low risk endocrine-responsive breast cancer there is still a benefit locally from using adjuvant radiation.
Nina Bijker, Netherlands Cancer Institute, Amsterdam
Patients who had excision of ductal carcinoma in situ (DCIS) gained longer freedom from recurrence if they received radiotherapy, according to findings from an EORTC trial. All sub-groups of patients benefited from radiation.
Amit Agrawal, Nottingham City Hospital
The epidermal growth factor receptor (EGFR) inhibitor gefitinib brought benefit to patients with advanced or metastatic breast cancer. Curiously, those with more modest expression of EGFR had the best responses.