Intermittent Extended Letrozole Fails in Postmenopausal Breast Cancer

Excerpt:

“An intermittent dosing schedule with extended adjuvant letrozole did not improve disease-free survival (DFS) over continuous treatment with the agent in postmenopausal women with hormone receptor–positive breast cancer, according to the randomized phase III SOLE trial.

” ‘The magnitude of the beneficial effect of 5 years of extended letrozole use in postmenopausal women who have previously received an aromatase inhibitor for 5 years is low,’ wrote study authors led by Marco Colleoni, MD, of the European Institute of Oncology in Milan, Italy. That small effect may be partially due to acquired resistance, and animal studies suggest that such resistance can be reversed by discontinuing treatment.”

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New Study Provides BRCA Mutation Carriers Guidance for When Surgery Has Greatest Impact

Excerpt:

“Of the women who carry the mutated BRCA1/2 genes, 45-65 percent will develop breast cancer, and 15-39 percent will develop ovarian cancer in their lifetimes. Many women, especially those who have experienced the death of family members to these cancers, elect to undergo preventive surgeries that can significantly increase life expectancy, but require extensive recovery time and can impact later fertility and quality-of-life. However, few guidelines exist that shed light on the optimal age to undergo these procedures, and in what sequence. A new study in the INFORMS journal Decision Analysis provides insight to help enable physicians and patients make better-informed choices.

“The study, ‘Was Angelina Jolie Right? Optimizing Cancer Prevention Strategies Among BRCA Mutation Carriers,’ was conducted by Eike Nohdurft and Stefan Spinler of the Otto Beisheim School of Management, and Elisa Long, of the UCLA Anderson School of Management.”

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Radiation Prior to Surgery Reduces Risk of Secondary Tumors in Early-Stage Breast Cancer

Excerpt:

“Moffitt Cancer Center researchers launched a first of its kind study comparing the long-term benefits of radiation therapy in women with breast cancer either before surgery (neoadjuvant) or after surgery (adjuvant). Their study, published in the June 30 issue of Breast Cancer Research, found that patients who have neoadjuvant radiation therapy have a significantly lower risk of developing a second primary tumor at any site.

“The majority of patients who have early stage breast cancer have surgery to remove their tumor or a complete mastectomy. Surgery is commonly followed by radiation therapy, which has been shown to increase relapse-free survival. However, in some cases, patients may require neoadjuvant radiation therapy to decrease the size of the tumor before surgery. Currently, there are no studies that have analyzed the long-term effects of neoadjuvant radiation therapy on breast cancer patients.”

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Further Reductions in Radiotherapy to Young Children With Brain Tumors Less Successful

Excerpt:

“A team of investigators has determined that young children participating in a clinical trial to assess the effectiveness of reduced radiotherapy did worse when there were deviations from the treatment protocol. Results of the study will be available online in advance of publication by Pediatric Blood & Cancer on April 4.

” ‘This study shows that attention to the timing, dose, and location of radiation therapy is crucial,’ Kenneth K. Wong, MD, a radiation oncologist at Children’s Hospital Los Angeles and first author on the study.

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Encouraging Results for Patients with Aggressive Brain Cancer

Excerpt:

“Being diagnosed with a malignant brain tumor is devastating news for patients and their loved ones. Whereas some types of tumor respond well to treatment, others such as glioblastomas – the most common and aggressive brain tumors – are known to recur and progress within short times from the diagnosis. Patients diagnosed with this type of cancer, and who undergo current standard treatment, have a median survival of 16 months.

Based on recent information on the mechanisms of chemotherapy, a team of researchers of the McGill University Health Centre (MUHC) developed a new clinical approach to increase the efficiency of treatment in glioblastomas that increased the median survival to 22 months – bringing much needed hope to those affected by this aggressive disease. The findings of this promising phase II clinical trial have been published in the International Journal of Radiology Oncology.”

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Updated Data on SBRT Radiation for NSCLC Lung Cancer Confirm Benefits of ‘One and Done’ Approach

Excerpt:

“New research led by a radiation oncologist at Roswell Park Cancer Institute indicates that less may be more when it comes to some forms of radiation therapy for cancer. In a presentation highlighted in a plenary session today at the Multidisciplinary Thoracic Cancers Symposium in San Francisco, California, Anurag Singh, MD, shared updated evidence that patients receiving stereotactic body radiation therapy (SBRT) as treatment for non-small cell lung cancer (NSCLC) benefit as much from a single fraction, or dose, of radiation as they would from the standard three-dose treatment schedule — and with significant advantages in terms of convenience for patients and caregivers.”

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Can Less Costly 9-Week Trastuzumab Match Efficacy of 12-Month Regimen?

Excerpt:

“A cost-effectiveness analysis found that 9 weeks of trastuzumab therapy is better than the more standard 12 months in patients with HER2-positive breast cancer, without loss of clinical efficacy. The analysis is limited, though, by the need to combine various trials rather than any head-to-head comparisons.

“Trastuzumab has been shown to significantly improve survival in women with HER2-positive disease. ‘The budget impact of trastuzumab is high, mostly due to the drug’s high cost, and the most serious adverse effect observed is cardiac dysfunction,’ wrote study authors led by Caroline Clarke, PhD, of University College London in the United Kingdom. Though 12 months is considered the standard duration of therapy, some studies have also found similar results with only 9 or 10 weeks of trastuzumab.”

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Expert Calls for Shorter Radiation Use in Prostate Cancer Treatment

Excerpt:

“Men with prostate cancer can receive shorter courses of radiation therapy than what is currently considered standard, according to Justin Bekelman, MD, an associate professor of Radiation Oncology, Medical Ethics, and Health Policy at the University of Pennsylvania’s Perelman School of Medicine and Abramson Cancer Center. In his call for practice change, Bekelman cites research showing the shorter radiation treatment — known as moderate hypofractionation — is just as effective at treating cancer, while costing less and easing the burden on patients. The commentary was published online by the International Journal of Radiation Oncology Biology and Physics and was co-authored by W. Robert Lee, MD, MEd, MS, a professor of Radiation Oncology at the Duke University School of Medicine.”

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Study Suggests Best Order of Treatment for Brain Metastases in EGFR Lung Cancer

Excerpt:

“About 10 percent of lung cancers in the United States and as many as 40 percent in Asia are driven by mutations in the EGFR gene. EGFR targeted treatment advances over the previous decade now result in multiple options for controlling the disease in the body, but due to the reduced ability of many of these drugs to penetrate into the brain, treating of disease in the brain remains challenging. When brain metastases are seen at diagnosis before a patient has tried EGFR-targeted drugs, it has been an open question whether doctors should try drugs alone just in case they work in the brain or move directly to whole-brain radiotherapy or stereotactic radiosurgery (a tightly focused form of radiation) first, followed by targeted medicines. A study published in the Journal of Clinical Oncology looks back at 351 patients with EGFR mutant lung cancer and brain metastases treated at six institutions to offer compelling preliminary evidence as to the best sequence of these techniques: Radiation followed by targeted medicines resulted in the longest overall survival.”

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