Men with AR-V7 Variant May Benefit from Taxanes for Advanced Prostate Cancer

“Men with advanced prostate cancer who have the androgen receptor splice variant-7 respond to chemotherapy equally as well as those who do not have the variant, according to findings from a small clinical trial.

“Further, taxane chemotherapy may be more effective than hormone therapy for men with the androgen receptor splice variant-7 (AR-V7).

” ‘The key finding from this study is that men with detectable AR-V7 in their circulating tumor cells may respond more favorably to chemotherapy (docetaxel or cabazitaxel [Jevtana, Sanofi]) compared to novel hormonal therapies (abiraterone and enzalutamide),’ Emmanuel S. Antonarakis, MBBCh, assistant professor of oncology and assistant professor of urology at the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, told HemOnc Today. ‘This finding was quite a relief because AR-V7–positive prostate cancer can be very lethal, and now we have at least one class of drugs that may work for these patients.’ ”


Adding Chemo Boosts Prostate Cancer Survival

“Mounting evidence supports the addition of docetaxel to standard hormone and radiation treatment in men with high-risk prostate cancer. This latest comes from a federally funded phase 3 clinical trial presented here at this year’s American Society of Clinical Oncology meeting.

“The 4-year overall survival rates were higher with docetaxel than standard therapy. The add-on chemotherapy was given for 18 weeks, starting a month after radiation.

” ‘This finding could improve outcomes for thousands of men,’ lead investigator Howard Sandler, MD, from Cedars-Sinai Medical Center in Los Angeles, said in a statement issued in advance of the news conference on the study. ‘We also expect to see an even bigger survival advantage over time,’ he said.”


Pfizer's Ibrance Drug Slows Progression of Breast Cancer

“A Phase III trial of Pfizer Inc’s Ibrance showed that, in combination with hormone therapy, the drug more than doubled the duration of disease control for women with the most common type of breast cancer.

“At the time of an interim analysis, patients given Ibrance and AstraZeneca Plc’s Faslodex (fulvestrant), a widely used treatment to block estrogen, lived an average of 9.2 months before their cancer worsened. This compared with 3.8 months for patients treated with Faslodex and a placebo.

“The trial, presented in Chicago at a meeting of the American Society of Clinical Oncology, enrolled 521 patients whose breast cancer was classified as estrogen-receptor positive, human epidermal growth factor receptor 2-negative. This category accounts for about 75 percent of all breast cancers.

“Ibrance, or palbociclib, was given conditional approval by the U.S. Food and Drug Administration in February for such patients, but only those who had not previously been treated for advanced breast cancer.”


Breast Cancer Patients Over 60 with Luminal a Subtype May Not Need Radiation if Already on Hormone Therapy

“Women with luminal A subtype breast cancer – and particularly those older than 60 – may not need radiation treatment if they are already taking hormone therapy, shows clinical research led by radiation oncologists at the Princess Margaret Cancer Centre published online today in the Journal of Clinical Oncology.

“The findings potentially advance delivery of personalized cancer medicine for up to 25% of women diagnosed with breast cancer in North America every year, say co-principal investigators Dr. Fei-Fei Liu, Chief, Radiation Medicine, and Dr. Anthony Fyles, staff radiation oncologist. Dr. Liu is Chair, Department of Radiation Oncology, University of Toronto, where Dr. Fyles is also a Professor. In Ontario alone, they estimate, this could save the provincial health care system up to $3 million annually. Drs. Liu and Fyles talk about their research at https://www.youtube.com/watch?v=mrl5-1gsoSg .

“They stress, however: ‘For all other breast cancer subtypes, radiation therapy is definitely of benefit and the required treatment.’
Drs. Liu and Fyles examined tumour specimens from participants in a prior randomized clinical trial who received either tamoxifen (hormone therapy) plus whole-breast radiation therapy, or only tamoxifen.”


Heart Health After Cancer: A Growing Concern

“Nearly 15 million people are living after a cancer diagnosis in the United States. This number represent over 4 percent of the population, an astonishing figure. And a growing one, as reported last year by the ACS and outlined by the NCI’s Office of Cancer Survivorship.

“As cancer patients survive longer they face additional health problems. Radiation to the chest, chemotherapy, antibody therapy and hormone changes can affect blood vessels and heart function in the short term and long, during treatment or years later. But millions affected – and their physicians – remain insufficiently mindful about the risk of heart disease.

“It’s the kind of problem a person who’s had cancer, or a doctor who’s prescribed generally helpful treatment, may not want to think about.

“Years ago, heart complications of cancer treatment didn’t garner so much attention says, Dr. Javid Moslehi, a cardiologist who leads a program in cardio-oncology at the Vanderbilt University School of Medicine in Nashville, TN. The emerging field involves cardiologists, oncologists, scientists and others who study the long-term effects of cancer treatment on the heart.”


Black Women Less Likely to Take Breast Cancer Hormone Therapy

“Among early-stage breast cancer patients in the U.S., black women are less likely than white women to take their prescribed hormone medications, according to a new study that partly – but not entirely – blames economic disparities between races.

“Black women are less likely to be diagnosed with breast cancer than white women, but more likely to die from it, a disparity that emerged in the 1980s and has widened ever since, the authors note in the introduction.

“When it comes to hormone prescriptions, women with fewer financial resources and higher prescription drug co-pays, which are more common for black women, are less likely to stick to the therapy, according to the new study that was led by Dr. Dawn L. Hershman of Herbert Irving Comprehensive Cancer Center at Columbia University in New York.

“For the study, Hershman’s team used an insurance claims database including more than 10,000 women over age 50 who were diagnosed with early-stage breast cancer between 2007 and 2011 and given a prescription for aromatase inhibitors or tamoxifen, both hormonal therapies.”


Now BATting: A New Treatment Approach That Uses Testosterone First, Then ADT


Androgen deprivation therapy (ADT) has long been a mainstay in the management of prostate cancer. Indeed, the vast majority of prostate cancers depend on androgens (hormones like testosterone) for their growth. Lowering testosterone levels with ADT is a reasonable approach. But it comes with two sets of problems. Continue reading…


Some Older Cancer Patients Can Avoid Radiotherapy, Study Finds

“Some older women with breast cancer could safely avoid radiotherapy, without harming their chances of survival, a study has shown.

“Older women with early breast cancer who are given breast-conserving surgery and hormone therapy gain very modest benefit from radiotherapy, researchers say.

“The findings suggest that a carefully defined group of patients who are at low risk of recurrence could avoid the health risks and side effects associated with radiotherapy, such as fatigue and cardiac damage.

“Currently older women with early hormone-sensitive breast cancer are offered surgery to remove their tumour, followed by hormone treatment and radiotherapy. Few trials have assessed the benefits of radiotherapy in older women treated by breast-conserving surgery.”


Radiation plus Hormone Therapy Prolongs Survival for Older Men with Prostate Cancer

“Adding radiation treatment to hormone therapy saves more lives among older men with locally advanced prostate therapy than hormone therapy alone, according to a new study in the Journal of Clinical Oncology this week from Penn Medicine researchers.

“The researchers found that hormone therapy plus radiation reduced deaths by nearly 50 percent in men aged 76 to 85 compared to men who only received hormone therapy. Past studies have shown that 40 percent of men with aggressive prostate cancers are treated with hormone therapy alone, exposing a large gap in curative cancer care among baby boomers aging into their 70s.

” ‘Failure to use effective treatments for older patients with cancer is a health care quality concern in the United States. Radiation plus hormone therapy is such a treatment for men with aggressive prostate cancers,’ said lead author Justin E. Bekelman, MD, an assistant professor of Radiation Oncology, Medical Ethics and Health Policy at Penn’s Perelman School of Medicine and Abramson Cancer Center. ‘Patients and their physicians should carefully discuss curative treatment options for and reduce the use of hormone therapy alone.’ “