“Two papers from UCL show that having early chemotherapy improves survival for men with prostate cancer. The papers, published in the Lancet and Lancet Oncology, report the results from the STAMPEDE clinical trial and a meta-analysis.
“Both papers looked at the use of a chemotherapy drug called docetaxel. Docetaxel is already used for men with prostate cancer once hormone therapy has stopped working. In STAMPEDE and the meta-analysis, the researchers looked at using it earlier, when men are starting long-term hormone therapy. Both studies found that adding docetaxel improved survival for these men.
“The studies also looked at whether the drug zoledronic acid improves survival. Zoledronic acid is used to reduce the risk of bone problems in men whose cancer has spread to their bones, and whose hormone therapy has stopped working. The new studies looked at using it earlier, when men are starting long-term hormone therapy. Both studies found that adding zoledronic acid did not improve survival for these men.”
“Data collected in Japanese and Korean patients included in the global PALOMA3 trial provides evidence that combining palbociclib with fulvestrant is an effective strategy to overcome endocrine resistance in women with hormone receptor positive (HR+), HER2 negative (HER2-) advanced breast cancer. The analysis of efficacy and safety of the combined therapy in an Asian population will be presented (1) at the first ESMO Asia 2015 Congress in Singapore, and results are in line with those reported in all patients (both Asian and non-Asian) earlier this year.
“Endocrine resistance is a major clinical issue that makes advanced breast cancer more difficult to treat. Hormone therapy is generally well tolerated and an easy-to-administer option for breast cancer, with demonstrated benefits in patients whose tumours express hormone receptors (HR), particularly the HR+/HER2- subgroup. The ideal option for patients is to be on one endocrine therapy after another, as long as the disease responds or remains unchanged. ‘However, unavoidably, resistance develops in almost all advanced patients a median ten months after the first-line hormonal agent is administered, and a much shorter median time after the second- or third-line hormonal agents, eventually driving patients to switch to the more toxic chemotherapy,’ one of the study authors, Dr. Jungsil Ro, Center for Breast Cancer at the National Cancer Center, Goyang, Korea, said.”
“Hormone therapy for prostate cancer might dramatically increase a man’s risk of developing Alzheimer’s disease, a large-scale analysis of health data suggests.
“Men who underwent androgen deprivation therapy (ADT) for their prostate cancer had nearly twice the risk of Alzheimer’s, when compared to prostate cancer patients who didn’t receive hormone therapy, researchers found.
“The risk increased even more if men received hormone therapy for longer than a year, said study lead author Dr. Kevin Nead, a radiation oncology resident at the University of Pennsylvania’s Perelman School of Medicine in Philadelphia.”
“Adding prostate and pelvic radiotherapy (RT) to hormone therapy appears to cut relapse rates in men newly diagnosed with high-risk nonmetastatic (M0) node-positive prostate cancer, according to an exploratory analysis by European investigators.
“In a November 25 online paper in JAMA Oncology, Dr. Nicholas D. James of the University of Warwick, Coventry, UK, and colleagues note that they came to this conclusion using data collected between 2005 and 2014 in 721 patients allocated to the control arm (standard-of-care only) of the STAMPEDE Trial.
“Dr. James told Reuters Health by email that these data ‘form part of a pair of publications detailing outcomes in the control arm of STAMPEDE and help to make sense of the forthcoming paper on the randomized comparisons currently in press at The Lancet.’ “
“Most breast cancer patients with invasive lobular carcinoma could be treated with hormones alone and not with chemotherapy, according to a study by Virginia Piper Cancer Institute at Abbott Northwestern Hospital, part of Allina Health.
“Researchers reviewed all consecutive cases of invasive lobular carcinoma breast cancer diagnosed at the Allina Health Laboratory from the past eight years. Included were 158 patients with invasive lobular carcinoma breast cancer who also had molecular testing with the Oncotype DX gene expression test.
“With Allina Health pathologists, researchers defined a model that included characteristics of a tumor most predictive of the recurrence risk identified on the Oncotype DX gene expression test: progesterone receptor expression, Ki-67 (proliferation index), estrogen receptor expression, patient age and tumor size.”
“Researchers report in theNew England Journal of Medicine (NEJM) the strongest evidence yet that some women with early stage breast tumors may not need chemotherapy to effectively treat their cancer. For some women, hormone-based anti-tumor drugs may be all they need to enjoy 98% survival at five years and a 93.8% chance of being free of invasive breast cancer in that time as well.
“The key to identifying these women lies with a gene-based test called Oncotype Dx, which scans 21 genes in the tumor to create a dossier of the tumor’s strengths and weaknesses. The information helps doctors to determine how potentially aggressive, or not, a tumor might be. Allowed on the market as a clinical laboratory test in 2004, it produces a recurrence score from 0 to 100 and helps doctors determine whether women should be treated with chemotherapy. Lower scores generally indicate that hormone-based drug therapies are enough, while higher recurrence scores push physicians to consider chemotherapy to lower the risk of the cancer returning.”
“Young women undergoing chemotherapy for breast cancer may be more likely to remain fertile if they also receive hormonal treatment, according to new research presented to the 2015 European Cancer Congress on Monday and published simultaneously in Annals of Oncology.
“Researchers will tell the Congress that the addition of treatment with a so-called luteinising hormone-releasing hormone analogue, or LHRHa, during chemotherapy, could protect women’s ovaries. The approach may increase the chances of pregnancy after breast cancer treatment.
“Dr Matteo Lambertini, MD, a medical oncologist at the IRCCS AOU San Martino-IST, Genoa, Italy, will say: ‘Chemotherapy can damage the ovaries and push young women into the menopause. They may experience infertility, sleep disturbance, sexual dysfunction and osteoporosis. It is psychologically distressing, harmful to health, and affects the treatment decisions of many young women.’
” ‘We found that temporary suppression of ovarian function with LHRHa significantly reduces the risk of premature ovarian failure (POF) caused by chemotherapy. It also seems to be associated with a higher pregnancy rate in young breast cancer patients.’ “
Pancreatic neuroendocrine tumors (PNETs) constitute only about 3% to 5% of all pancreatic cancers. Compared to the most common pancreatic cancer—adenocarcinoma (aka exocrine tumors), PNETs have a longer disease course and better prognosis; the 5-year survival rate is 42% for PNETs, but only about 5% to 6% for adenocarcinomas. When PNETs are localized, they can usually be removed by surgery. However, PNETs tend to metastasize, most often to the liver, and present a formidable treatment challenge at this stage. Continue reading…
“Patients who received hormonal regimens for the treatment of castration-resistant prostate cancer experienced a significant increase in incidence of and relative risk for cardiovascular toxicity, according to results of a meta-analysis.
“Roberto Iacovelli, MD, medical oncologist in the division of urogenital and head and neck tumors at European Institute of Oncology in Milan, and colleagues sought to define the incidence and RR of cardiovascular events in a population of patients treated with new hormonal therapies for metastatic castration-resistant prostate cancer.
“Incidence of all-grade toxicities (grades 1-4) and high-grade toxicities (grade 3-4) served as the primary outcome of the study.
“Iacovelli and colleagues identified six prospective phase 2 or phase 3 studies that included a total of 7,830 patients. Within each study, researchers considered treatment with a novel hormonal agent plus prednisone in the experimental arm (n = 4,520) and placebo plus prednisone (n = 3,310) as the control.”