Use of Anthracyclines Plus Taxanes Found to be Beneficial in Early, HER2-Negative Breast Cancer

Excerpt:

“Treatment with anthracyclines was proven to be beneficial for patients with high-risk, HER2-negative, early-stage breast cancer, according to a joint analysis of the “ABC” trials presented at the 2016 ASCO Annual Meeting.

“The analysis, which included more than 4000 patients, demonstrated that docetaxel plus cyclophosphamide (TC) was significantly inferior to various taxane-plus-anthracycline-based (TaxAC) chemotherapy regimens.

“ ‘Statistical noninferiority of the non-anthracycline regimen could not be demonstrated,’ said lead investigator Joanne Lorraine Blum, MD, PhD, medical oncologist with Texas Oncology at the Baylor-Sammons Cancer Center in Dallas. ‘In terms of the study’s primary endpoint, invasive disease-free survival, TC x 6 was significantly inferior to TaxAC.’ ”

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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.’ ”


Treatment of Stage I Breast Cancer Has Intensified over Time

“The use of intense, taxane-based regimens in patients with stage I breast cancer has increased over the last decade, according to study results.

“However, the choice of regimen and its cost tended to vary according to the treating institution, results showed.

“ ‘Stage I breast cancers represent nearly one-half of early breast cancer diagnoses and generally have an excellent prognosis,’ Nancy U. Lin, MD, of the department of medical oncology at Dana-Farber Cancer Institute, and colleagues wrote. ‘However, some patients have a significant risk of disease recurrence to drive a recommendation for adjuvant chemotherapy … To our knowledge, patients with stage I disease have generally been excluded or underrepresented in [phase 3] trials and, therefore, there is uncertainty regarding the preferred chemotherapy for these individuals.’

“Lin and colleagues evaluated data from 8,907patients with stage I breast cancer who underwent treatment at a National Comprehensive Cancer Network center between 2000 and 2009.”


A Breast Cancer Tumor's Immune Signature Could Predict Response to Neoadjuvant Therapy

“In a study reported in the Journal of Clinical Oncology, Denkert et al found that increased tumor-infiltrating lymphocytes and the presence of lymphocyte-predominant breast cancer were associated with increased rates of pathologic complete response in patients receiving neoadjuvant anthracycline-taxane treatment with or without carboplatin. Higher rates were observed with carboplatin, with treatment interactions being significant among all patients and among those with HER2-positive disease but not among those with triple-negative disease. mRNA profiles for immune-related genes also distinguished pathologic complete response rates.

“The study involved 580 tumors from patients in the GeparSixto trial, which assessed the effects on pathologic complete response rates of adding carboplatin to neoadjuvant anthracycline plus taxane treatment. The current analysis assessed the effects on pathologic complete response of tumor-infiltrating lymphocyte levels, the presence of lymphocyte–predominant disease, and levels of immune-activating (CXCL9, CCL5, CD8A, CD80, CXCL13, IGKC, CD21) and immunosuppressive genes (IDO1, PD-1, PD-L1, CTLA4, FOXP3).”


Cabazitaxel May Be More Effective Than Docetaxel in Some Prostate Cancer Patients

“In a new study reported by de Leeuw et al in Clinical Cancer Research, researchers found that the novel taxane cabazitaxel (Jevtana) has properties that could make it more effective than docetaxel in some patients with advanced prostate cancer. This hypothesis is currently being tested in a phase II clinical trial. Researchers have also found a genomic marker that could help physicians identify which patients might benefit most from cabazitaxel.

“ ‘It was surprising to find that cabazitaxel functions differently than docetaxel in killing cancer cells, even though they’re both taxanes,’ said senior author  and Professor of Cancer Biology at the Sidney Kimmel Medical College at Thomas Jefferson University. ‘It shows that we may not be taking full advantage of this next-generation taxane in the clinic.’

“For years, docetaxel has been the only effective chemotherapy for men whose prostate cancer was no longer responding to hormone treatments. The next-generation drug in the taxane family, cabazitaxel, was approved by the U.S. Food and Drug Administration (FDA) in 2010, but only for patients whose prostate cancer no longer responded to hormone therapy or docetaxel treatment.

“Dr. Knudsen and colleagues explored how cabazitaxel worked and demonstrated that it might be more effective sooner in treatment. The researchers showed that cabazitaxel worked better than docetaxel in human prostate cancer cells lines that were resistant to hormone treatment, both in terms of slowing growth of cancer cells and in its ability to kill cancer cells.”


Cabazitaxel May Be More Effective against Certain Types of Prostate Cancer

“Prostate cancer is the second leading cause of cancer for men in the United States. Only one class of chemotherapy called taxanes is effective against the disease. A study published online this week (January 17th) in Clinical Cancer Research, researchers have found that a newer member of the taxane family called cabazitaxel, an FDA approved drug, has properties that could make it more effective for some patients – a hypothesis currently being tested in clinical trials. Researchers also found a genomic marker that could help physicians identify which patients might benefit most from cabazitaxel.

” ‘It was surprising to find that cabazitaxel functions differently than docetaxel in killing cancer cells, even though they’re both taxanes,’ says senior author Karen Knudsen, Ph.D., Interim Director of the Sidney Kimmel Cancer Center and a professor of cancer biology at the Sidney Kimmel Medical College at Thomas Jefferson University. ‘It shows that we may not be taking full advantage of this next generation taxane in the clinic.’

“For years, docetaxel has been the only effective chemotherapy for men whose cancer was no longer responding to hormone treatments. The next generation drug in the taxane family, cabazitaxel, was approved in 2010, but only for patients whose cancer no longer responded to hormone therapy or docetaxel treatment.”


First Treatment for Pain Caused by Chemotherapy

Conventional chemotherapy can damage nerves, causing pain and numbness, particularly in the hands and feet. Called neuropathy, this side effect can last months or even years after the completion of chemotherapy and there are currently no effective treatments. A new JAMA study shows that chemotherapy-induced neuropathy can be lessened with a drug called duloxetine (Cymbalta), which has also been shown to alleviate neuropathy in people with diabetes. The new study included 231 people who reported pain of at least 4 (on a scale of 0 to 10) after treatment with oxaliplatin or taxanes such as paclitaxel. Nearly 60% of those treated with duloxetine reported pain relief and those who had been treated with oxaliplatin may have benefited the most.


First Treatment for Pain Caused by Chemotherapy

Conventional chemotherapy can damage nerves, causing pain and numbness, particularly in the hands and feet. Called neuropathy, this side effect can last months or even years after the completion of chemotherapy and there are currently no effective treatments. A new JAMA study shows that chemotherapy-induced neuropathy can be lessened with a drug called duloxetine (Cymbalta), which has also been shown to alleviate neuropathy in people with diabetes. The new study included 231 people who reported pain of at least 4 (on a scale of 0 to 10) after treatment with oxaliplatin or taxanes such as paclitaxel. Nearly 60% of those treated with duloxetine reported pain relief and those who had been treated with oxaliplatin may have benefited the most.


First Treatment for Pain Caused by Chemotherapy

Conventional chemotherapy can damage nerves, causing pain and numbness, particularly in the hands and feet. Called neuropathy, this side effect can last months or even years after the completion of chemotherapy and there are currently no effective treatments. A new JAMA study shows that chemotherapy-induced neuropathy can be lessened with a drug called duloxetine (Cymbalta), which has also been shown to alleviate neuropathy in people with diabetes. The new study included 231 people who reported pain of at least 4 (on a scale of 0 to 10) after treatment with oxaliplatin or taxanes such as paclitaxel. Nearly 60% of those treated with duloxetine reported pain relief and those who had been treated with oxaliplatin may have benefited the most.