MedWorm: Endocrine Therapy

Personalized therapy in breast cancer.

Onkologie — Mon, 06 Feb 2012 02:58:36 +0100

Authors: Marmé F, Schneeweiss A Abstract Systemic treatment of non-metastatic breast cancer is based on endocrine therapy, cytotoxic chemotherapy, and molecular targeted therapy - with the major problems of immense overtreatment of patients who would not relapse without systemic therapy and the failure of treatment in others whose disease still recurs. These deficits can only be overcome by the identification of new and better prognostic and predictive markers. Currently, adjuvant treatment stratification is based on a limited number of established factors, namely locoregional tumour stage, age, grade, expression of hormone receptors, HER2, and Ki-67. Molecular profiling techniques, however, have revolutionized our understanding of breast cancer as a heterogeneous disease. Future ...

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endocrine therapies for breast cancer

About.com Breast Cancer — Sun, 05 Feb 2012 05:00:00 +0100

Estrogen receptor-positive breast cancer can be treated with endocrine therapies, also called hormonal therapies. These drugs come in two classes: selective estrogen receptor modulators (SERMs)and aromatase inhibitors. These lower your estrogen levels, and may affect your fertility, as well as preventing a recurrence of breast cancer. Learn more about endocrine therapies for breast cancer. (Source: About.com Breast Cancer)

[Articles] Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100 000 women in 123 randomised trials

LANCET — Sat, 04 Feb 2012 05:00:00 +0100

10-year gains from a one-third breast cancer mortality reduction depend on absolute risks without chemotherapy (which, for oestrogen-receptor-positive disease, are the risks remaining with appropriate endocrine therapy). Low absolute risk implies low absolute benefit, but information was lacking about tumour gene expression markers or quantitative immunohistochemistry that might help to predict risk, chemosensitivity, or both. (Source: LANCET)

Inactivation of GPR30 reduces growth of triple-negative breast cancer cells: possible application in targeted therapy

Breast Cancer Research and Treatment — Mon, 30 Jan 2012 16:07:44 +0100

Abstract Triple-negative breast cancers lack estrogen receptor α (ERα), progesterone receptor, and do not overexpress human epidermal growth factor receptor 2 (Her-2). They are neither susceptible to endocrine therapy nor to a therapy using the anti-Her-2 antibody, trastuzumab. Therefore, an efficient targeted therapy is warranted. Triple-negative breast tumors frequently express membrane bound estrogen receptor G-protein coupled receptor (GPR30). As proof of principle, we analyzed the consequences of a knock-down of GPR30 expression on the growth regulation of triple-negative breast cancer cell lines. Cells of triple-negative breast cancer cell lines were transfected with siRNA against GPR30 or control siRNA, and cell growth was stimulated either with 10−9 M 17β-estr...

Dose-dependent change in biomarkers during neoadjuvant endocrine therapy with fulvestrant: results from NEWEST, a randomized Phase II study

Breast Cancer Research and Treatment — Fri, 27 Jan 2012 17:55:30 +0100

Abstract NEWEST (Neoadjuvant Endocrine Therapy for Women with Estrogen-Sensitive Tumors) is the first study to compare biological and clinical activity of fulvestrant 500 versus 250 mg in the neoadjuvant breast cancer setting. We hypothesized that fulvestrant 500 mg may be superior to 250 mg in blocking estrogen receptor (ER) signaling and growth. A multicenter, randomized, open-label, Phase II study was performed to compare fulvestrant 500 mg (500 mg/month plus 500 mg on day 14 of month 1) versus fulvestrant 250 mg/month for 16 weeks prior to surgery in postmenopausal women with ER+ locally advanced breast cancer. Core biopsies at baseline, week 4, and surgery were assessed for biomarker changes. Primary endpoint: change in Ki67 labe...

The role of chemoradiotherapy in patients with unresectable T4 breast tumors.

Breast Cancer — Wed, 25 Jan 2012 05:00:00 +0100

CONCLUSION: Chemoradiotherapy represents a viable option for local treatment of unresectable T4 breast tumors. PMID: 22274798 [PubMed - as supplied by publisher] (Source: Breast Cancer)

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Early Data from the First Population-Wide Breast Cancer-Specific Registry in Hong Kong

World Journal of Surgery — Tue, 24 Jan 2012 07:55:22 +0100

Conclusions The HKBCR serves as a surveillance program to monitor disease and treatment patterns. It is pivotal to support research for more effective breast cancer prevention and treatment strategies in Hong Kong. Content Type Journal ArticlePages 1-7DOI 10.1007/s00268-012-1426-2Authors Polly Cheung, Hong Kong Breast Cancer Foundation, 22/F, Jupiter Tower, No. 9, Jupiter Street North Point, Hong Kong, ChinaW. K. Hung, Hong Kong Breast Cancer Foundation, 22/F, Jupiter Tower, No. 9, Jupiter Street North Point, Hong Kong, ChinaCatherine Cheung, Hong Kong Breast Cancer Foundation, 22/F, Jupiter Tower, No. 9, Jupiter Street North Point, Hong Kong, ChinaAmy Chan, Hong Kong Breast Cancer Foundation, 22/F, Jupiter Tower, No. 9, Jupiter Street North Point, Hong Kong, ChinaT....

Phase II Trial of Simple Oral Therapy with Capecitabine and Cyclophosphamide in Patients with Metastatic Breast Cancer: SWOG S0430.

The Oncologist — Fri, 20 Jan 2012 05:00:00 +0100

Conclusions. PFS, OS, and RR outcomes with capecitabine plus CPA compare favorably with those of capecitabine monotherapy and combination therapy with bevacizumab, sorafenib, or ixabepilone. The addition of these other agents to capecitabine does not improve OS time in MBC patients, and this single-arm study does not suggest that the addition of CPA to capecitabine has this potential in an unselected MBC population. When OS prolongation is the goal, clinicians should choose single-agent capecitabine. PMID: 22267853 [PubMed - as supplied by publisher] (Source: The Oncologist)

Epithelial-mesenchymal transition, cancer stem cells and treatment resistance

Breast Cancer Research — Thu, 19 Jan 2012 05:00:00 +0100

Mortality from breast cancer has steadily been declining over the last decade, primarily due to earlier detection, adjuvant therapies and the advent of targeted therapies for ER positive and HER2 positive cancers [1, 2]. Despite these advances, a large number of patients relapse after an initial response to standard of care therapy. Novel therapies that prevent breast cancer relapse and metastasis are needed. An emerging hypothesis is that tumors contain a subpopulation of cells, called cancer stem cells (CSCs), which have the ability to self renew and regenerate the tumor. Increasingly, clinical evidence points to an intrinsic resistance to endocrine therapy and chemotherapy of this subpopulation of cancer stem cells [3]. The residual tumors after chemotherapy are enriched for CSCs and ha...

Scriptaid Revives Breast Cancer Treatment Receptivity

Health News from Medical News Today — Wed, 18 Jan 2012 18:00:00 +0100

A study by researchers from the Sbarro Institute for Cancer Research and Molecular Medicine, reveals that despite the effectiveness of endocrine therapy for breast cancer, responsiveness to the treatment depends on expression of estrogen receptors in breast cancer cells. However, Dr. Laura Giacinti, lead investigator of the study reports on a new molecule, Scriptaid, which revives receptivity to the treatment in breast cancer cell lines that previously tested negative for the expression of estrogen receptors. The study appears in the Journal of Cellular Physiology. Dr... (Source: Health News from Medical News Today)

First-line endocrine therapy alone could be a reasonable treatment option for hormone-positive, HER2-positive metastatic breast cancer.

Bulletin du Cancer — Tue, 17 Jan 2012 05:00:00 +0100

Conclusions. Our result suggests that first-line endocrine therapy is a viable therapeutic option for a selected population of metastatic breast cancer patients with HER2-positive tumors. Genomic and transcriptomic signature could help to identify tumors that remain dependant of estrogen-signaling pathway. PMID: 22257781 [PubMed - as supplied by publisher] (Source: Bulletin du Cancer)

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The therapeutic and diagnostic potential of FKBPL; a novel anticancer protein.

Drug Discovery Today — Mon, 16 Jan 2012 05:00:00 +0100

Authors: Robson T, James IF Abstract The immunophilin family of proteins has a vast number of roles regulating a variety of biological processes through protein-protein interactions. A relatively new and divergent member of this family, FK506-binding protein like (FKBPL), is emerging as a key player in the DNA damage response, steroid receptor signalling and more recently, control of tumour growth where it regulates response to endocrine therapy in addition to acting as a novel antiangiogenic protein. As a new therapeutic peptide based on FKBPL approaches clinical trials. In this article we highlight a unique approach to targeting tumours that are resistant to current antiangiogenic therapies and we support the role of FKBPL as a novel prognostic and predictive biomarker, distinct ...

Response to “Timing of Radiotherapy and Outcome in Patients Receiving Adjuvant Endocrine Therapy.” (Int J Radiat Oncol Biol Phys 2011;80:398–402)

International Journal of Radiation Oncology * Biology * Physics — Sat, 14 Jan 2012 19:43:01 +0100

To the Editor: In their recent article, Karlsson et al. argue that in patients who receive solely hormone treatment, a delay of radiotherapy delivery of less than 20 weeks after breast-conserving surgery is irrelevant to inferior outcomes . (Source: International Journal of Radiation Oncology * Biology * Physics)

Health-related quality of life, psychological distress, and adverse events in postmenopausal women with breast cancer who receive tamoxifen, exemestane, or anastrozole as adjuvant endocrine therapy: National Surgical Adjuvant Study of Breast Cancer 04 (N-SAS BC 04)

Breast Cancer Research and Treatment — Tue, 10 Jan 2012 16:49:30 +0100

Abstract Health-related quality of life (HRQOL), symptoms of depression, and adverse events (AEs) were compared between Japanese postmenopausal patients with hormone-sensitive breast cancer (BC) who received adjuvant tamoxifen, exemestane, or anastrozole in an open-labeled, randomized, multicenter trial designated as the National Surgical Adjuvant Study of Breast Cancer (N-SAS BC) 04 substudy of the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial. During the first year of treatment, HRQOL and symptoms of depression were analyzed using the Functional Assessment of Cancer Therapy-Breast (FACT-B) and its Endocrine Symptom Subscale (ES), and the Center for Epidemiologic Studies Depression Scale (CES-D), respectively. In addition, predefined AEs were analyzed. A total ...

Higher expression of androgen receptor is a significant predictor for better endocrine-responsiveness in estrogen receptor-positive breast cancers

Breast Cancer Research and Treatment — Mon, 09 Jan 2012 19:38:26 +0100

Abstract The aim was to investigate the implications of androgen receptor (AR) expression levels on outcomes for estrogen receptor (ER)-positive tumors. Immunohistochemically AR levels were determined from tissue microarrays of 614 ER-positive patients who received adjuvant endocrine with or without chemotherapy between November 1999 and August 2005. Characteristics and survival were analyzed using a Chi-square test, Kaplan–Meier methods, and Cox’s models. AR levels were categorized into 3 subgroups as follows: low, AR < 10%; intermediate, 10% ≤ AR < 50%; high, AR ≥ 50%. Low, intermediate, and high AR levels were observed in 29.0, 44.0, and 27.0% of patients, respectively. High AR was associated with smaller size, nodal ...

Anticancer drugs in surface waters What can we say about the occurrence and environmental significance of cytotoxic, cytostatic and endocrine therapy drugs?

Environment International — Mon, 09 Jan 2012 16:19:58 +0100

This study considers the implications and research needs arising from anticancer (also referred to as antineoplastic) drugs being released into the aquatic environment, for the entire therapeutic classes used: cytotoxic, cytostatic and endocrine therapy drugs. A categorization approach, based on French consumption amounts, allowed to highlight parent molecules and several metabolites on which further occurrence and ecotoxicological studies should be conducted. Investigations of consumption trends at a national and a local scale show an increase in the use of anticancer drugs between 2004 and 2008, thus leading to increased levels released in the environment. It therefore appears necessary to continue surveying their presence in surface waters and in wastewater treatment plant (WWTP) efflue...

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[Modern pharmacological therapy of breast cancer].

Orvosi Hetilap — Sat, 07 Jan 2012 13:48:40 +0100

Authors: Láng I, Kahán Z, Hitre E, Dank M, Rubovszky G, Horváth Z, Kásler M Abstract Healthy lifestyle, population-based screening mammography and modern medical-oncological treatment in specialized breast cancer centers are the basic elements of the fight against breast cancer mortality. Treatment plan for the individual patient should be recommended by multidisciplinary oncoteam before initiating definitive therapy. Strategy of the medical-oncological therapy of breast cancer is determined by the biological features and stage of the tumor. The most important biological features are endocrine sensitivity, Human Epidermal Growth Factor Receptor 2 status and proliferative capability of the tumor. In this review the strategy of medical-oncological treatment (chemotherapy, endocri...

Vaginal estrogen therapy in postmenopausal breast cancer patients treated with aromatase inhibitors

Archives of Gynecology and Obstetrics — Mon, 02 Jan 2012 16:53:22 +0100

Conclusions Vaginal administration of estradiol is a well known and safe alternative to systemic estrogen therapy, but studies demonstrated significant increases in plasma concentrations of estradiol. Such observations have also been reported in postmenopausal breast cancer patients treated with AIs. Further studies are needed to explore risk of breast cancer recurrence after vaginal estrogen application for patients on adjuvant endocrine therapy with AIs. Content Type Journal ArticleCategory Gynecologic OncologyPages 1-6DOI 10.1007/s00404-011-2181-6Authors M. Moegele, Department of Obstetrics and Gynecology, University Medical Center Regensburg, Landshuter Str. 65, 93053 Regensburg, GermanyS. Buchholz, Department of Obstetrics and Gynecology, University Medical Ce...

Global Characterization of the SRC-1 Transcriptome Identifies ADAM22 as an ER-Independent Mediator of Endocrine-Resistant Breast Cancer

Cancer Research — Mon, 02 Jan 2012 05:00:00 +0100

The development of breast cancer resistance to endocrine therapy results from an increase in cellular plasticity that permits the emergence of a hormone-independent tumor. The steroid coactivator protein SRC-1, through interactions with developmental proteins and other nonsteroidal transcription factors, drives this tumor adaptability. In this discovery study, we identified ADAM22, a non-protease member of the ADAM family of disintegrins, as a direct estrogen receptor (ER)-independent target of SRC-1. We confirmed SRC-1 as a regulator of ADAM22 by molecular, cellular, and in vivo studies. ADAM22 functioned in cellular migration and differentiation, and its levels were increased in endocrine resistant-tumors compared with endocrine-sensitive tumors in mouse xenograft models of human breast ...

Age-Specific Nonpersistence of Endocrine Therapy in Postmenopausal Patients Diagnosed with Hormone Receptor-Positive Breast Cancer: A TEAM Study Analysis.

The Oncologist — Fri, 30 Dec 2011 05:00:00 +0100

Conclusion. Nonpersistence within 1 year of follow-up was associated with lower breast cancer-specific and overall survival probabilities in patients aged <65 years, but it was not associated with survival outcomes in patients aged 65-74 years or in patients aged ≥75 years. These results suggest that extrapolation of outcomes from a young to an elderly breast cancer population may be insufficient and urge age-specific breast cancer studies. PMID: 22210087 [PubMed - as supplied by publisher] (Source: The Oncologist)

Scriptaid effects on breast cancer cell lines

Journal of Cellular Physiology — Thu, 29 Dec 2011 05:00:00 +0100

AbstractIn breast cancer tumor expression of estrogen receptors (ERs) is important as a marker of prognosis and mostly as a predictor of response to endocrine therapy. In fact, the loss of α‐ER expression leads to unresponsiveness to anti‐hormone treatment. In a significant fraction of breast cancers, this loss of expression is a result of epigenetic mechanisms, such as DNA methylation and histone deacetylation, within the α‐ER promoter. Previous studies have shown that pharmacologic inhibition of these mechanisms using the DNA methyltransferase inhibitor, 5‐aza‐2‐deoxycytidine (AZA), and the histone deacetylase (HDAC) inhibitor, Trichostatin A (TSA), results in expression of functional α‐ER mRNA and protein. Moreover, the activity of a novel HDAC inhibitor, Scriptaid, has...

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The importance of combined radiation and endocrine therapy in locally advanced prostate cancer.

Asian Journal of Andrology — Mon, 26 Dec 2011 05:00:00 +0100

Authors: Gray PJ, Shipley WU PMID: 22198629 [PubMed - as supplied by publisher] (Source: Asian Journal of Andrology)

Molecular pathology of pre-invasive breast disease in the screening setting: application in diagnosis and management

Diagnostic Histopathology — Thu, 22 Dec 2011 05:00:00 +0100

We present a review of the molecular pathology of common pre-invasive lesions of the breast particularly discussing diagnosis on needle core biopsy, their risk of progression, and clinical management following their mammographic detection. (Source: Diagnostic Histopathology)

Assessment of response to endocrine therapy using FDG PET/CT in metastatic breast cancer: a pilot study

European Journal of Nuclear Medicine and Molecular Imaging — Tue, 20 Dec 2011 06:48:55 +0100

Conclusion Metabolic response assessed by FDG PET/CT imaging in patients with metastatic breast cancer treated with endocrine therapy is predictive of the patients’ PFS. Content Type Journal ArticleCategory Original ArticlePages 1-11DOI 10.1007/s00259-011-1981-zAuthors Nina Mortazavi-Jehanno, Service de Médecine nucléaire, Institut Curie, Hôpital René Huguenin, 35 rue Dailly, 92210 Saint-Cloud, FranceAnne-Laure Giraudet, Service de Médecine nucléaire, Institut Curie, Hôpital René Huguenin, 35 rue Dailly, 92210 Saint-Cloud, FranceLaurence Champion, Service de Médecine nucléaire, Institut Curie, Hôpital René Huguenin, 35 rue Dailly, 92210 Saint-Cloud, FranceFlorence Lerebours, Service d’oncologie médicale, Institut Curie, Hôpital René Huguenin, 92210...

Molecular Classification of Estrogen Receptor-positive/Luminal Breast Cancers

Advances in Anatomic Pathology — Fri, 16 Dec 2011 17:50:17 +0100

Estrogen receptor (ER)-positive breast cancer is the most prevalent subtype of invasive breast cancers. Patients with ER-positive breast cancers have variable clinical outcomes and responses to endocrine therapy and chemotherapy. With the advent of microarray-based gene expression profiling, unsupervised analysis methods have resulted in a classification of ER-positive disease into subtypes with different outcomes (ie, luminal A and luminal B); subsequent studies have demonstrated that these subtypes have different patterns of genetic aberrations and outcome. Studies based on supervised methods of microarray analysis have led to the development of prognostic gene signatures that identify a subgroup of ER-positive breast cancer patients with excellent outcome, who could forego chemotherapy....

Yoga for persistent fatigue in breast cancer survivors

Cancer — Fri, 16 Dec 2011 05:00:00 +0100

CONCLUSIONS:A targeted yoga intervention led to significant improvements in fatigue and vigor among breast cancer survivors with persistent fatigue symptoms. Cancer 2012;. © 2011 American Cancer Society. (Source: Cancer)

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Racial disparity in estrogen receptor positive breast cancer patients receiving trimodality therapy.

Breast — Fri, 16 Dec 2011 05:00:00 +0100

CONCLUSIONS: Black women had worse survival outcomes in this cohort. This disparity was driven by (1) a higher proportion of ER- and TN tumors in black women and (2) worse outcome of similarly treated black women with ER+ breast cancer. The underlying causes of racial disparity within hormone receptor categories must be further examined. PMID: 22178596 [PubMed - as supplied by publisher] (Source: Breast)

Complementary and alternative medicines use by Scottish women with breast cancer. What, why and the potential for drug interactions?

European Journal of Clinical Pharmacology — Tue, 13 Dec 2011 17:05:34 +0100

Conclusion The level of CAM use by Scottish breast cancer patients is similar to that reported from other countries, although there are marked differences in the type, nature and frequency of specific CAM therapies. Higher patient education level and use by family and friends were significantly associated with CAM use. The high level of use of potentially disease modifying or interacting herb supplements may be of concern. Content Type Journal ArticleCategory Pharmacoepidemiology and PrescriptionPages 1-9DOI 10.1007/s00228-011-1181-6Authors J. S. McLay, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, AB25 2ZG UKD. Stewart, Robert Gordon University, Aberdeen, UKJ. George, Robert Gordon University, Aberdeen, UKC. Rore, NHS Grampian, Aberdeen, U...

SABCS: Bone Drug Gives DFS Boost in Breast Cancer (CME/CE)

MedPage Today OB/GYN — Sat, 10 Dec 2011 13:00:00 +0100

SAN ANTONIO (MedPage Today) -- All but the youngest patients with hormone-sensitive breast cancer had significant improvement in disease-free survival when they received zoledronic acid in addition to endocrine therapy, results of two large trials showed. (Source: MedPage Today OB/GYN)

Spore Powder of Ganoderma lucidum Improves Cancer-Related Fatigue in Breast Cancer Patients Undergoing Endocrine Therapy: A Pilot Clinical Trial

Advances in Pharmacological Sciences — Sat, 10 Dec 2011 07:07:09 +0100

The fatigue prevalence in breast cancer survivors is high during the endocrine treatment. However, there are few evidence-based interventions to manage this symptom. The aim of this study was to investigate the effectiveness of spore powder of Ganoderma lucidum for cancer-related fatigue in breast cancer patients undergoing endocrine therapy. Spore powder of Ganoderma lucidum is a kind of Basidiomycete which is a widely used traditional medicine in China. 48 breast cancer patients with cancer-related fatigue undergoing endocrine therapy were randomized into the experimental or control group. FACT-F, HADS, and EORTC QLQ-C30 questionnaires data were collected at baseline and 4 weeks after treatment. The concentrations of TNF-α, IL-6, and liver-kidney functions were measured before and ...

PAM50 Gene Signature Can Estimate Residual Risk of Recurrence in Hormone Receptor–Positive Patients Treated With Endocrine Therapy

Clinical Care Options Oncology - Breast Cancer — Fri, 09 Dec 2011 17:41:41 +0100

Capsule Summary - In this large-scale comparison of predictors of disease recurrence, the PAM50 risk of recurrence score was significantly associated with 10-year risk of distant recurrence following treatment with anastrozole or tamoxifen and provided a greater level of additional prognostic information than the 21-gene recurrence score. (Source: Clinical Care Options Oncology - Breast Cancer)

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Immediate Bisphosphonate Use With Endocrine Therapy Reduced Recurrence And Increased Survival In Postmenopausal Early Breast Cancer

Health News from Medical News Today — Fri, 09 Dec 2011 08:00:00 +0100

The addition of zoledronic acid to adjuvant endocrine therapy increased bone mineral density and reduced the risk for disease recurrence among postmenopausal women with early hormone receptor-positive breast cancer, according to new data from the ZO-FAST trial. Richard de Boer, M.D., of the Royal Melbourne Hospital in Victoria, Australia, presented long-term data from the Zometa-Femara Adjuvant Synergy Trial (ZO-FAST) trial at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, held Dec. 6-10, 2011... (Source: Health News from Medical News Today)

SABCS: Hormone Combo Slows Metastatic Breast Cancer (CME/CE)

MedPage Today Hematology/Oncology — Thu, 08 Dec 2011 19:44:57 +0100

SAN ANTONIO (MedPage Today) -- Women with metastatic, hormone-sensitive breast cancer lived about six months longer when treated with two endocrine therapies instead of one, results of a randomized trial showed. (Source: MedPage Today Hematology/Oncology)

ABCSG-12: 7-Year Results Show Durable Improvement in DFS With Adjuvant Zoledronic Acid in Premenopausal Women With Endocrine-Responsive Early Breast Cancer

Clinical Care Options Oncology - Breast Cancer — Thu, 08 Dec 2011 15:32:07 +0100

Capsule Summary - At a median follow-up of 84 months, results from ABCSG-12 demonstrate that DFS and OS are significantly improved by the addition of zoledronic acid to adjuvant endocrine therapy; however, the survival benefits of zoledronic acid in this study may be restricted to patients older than 40 years of age. (Source: Clinical Care Options Oncology - Breast Cancer)

Obesity Linked To Worse Outcomes In Early Breast Cancer Treatment

Health News from Medical News Today — Thu, 08 Dec 2011 11:00:00 +0100

Obesity is associated with worse outcomes overall in early-stage breast cancer, researchers reported at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, held Dec. 6-10, 2011. Obesity was linked to shorter time to recurrence (TTR), disease-free survival (DFS) and overall survival (OS). The exception was treatment with endocrine therapy (mainly tamoxifen), in which obesity was associated with a protective effect... (Source: Health News from Medical News Today)

Identifying Interventions To Delay Or Prevent Breast Cancer Recurrences After Tamoxifen

Health News from Medical News Today — Thu, 08 Dec 2011 09:00:00 +0100

An international research team led by Georgetown Lombardi Comprehensive Cancer Center has found biological differences in hormone-receptor positive breast cancer that are linked to the timing of recurrence despite endocrine therapy. They say their findings, presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, may help oncologists find ways to individualize systemic therapy to delay or prevent recurrences, and to avoid excessive treatment of patients who will never recur... (Source: Health News from Medical News Today)

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Everolimus in postmenopausal hormone-receptor-positive advanced breast cancer: RCT

NeLM - News — Thu, 08 Dec 2011 05:00:00 +0100

Source: N Engl J Med Area: News The study of resistance to endocrine therapies in hormone receptor-positive breast cancer has aimed at identifying new therapeutic strategies that would enhance the efficacy of endocrine therapies. An emerging mechanism of endocrine resistance is activation of the mammalian target of rapamycin (mTOR) intracellular signaling pathway. Everolimus inhibits mTOR and in early studies, showed antitumor activity when added to endocrine therapy. The phase III randomised BOLERO-2 study compared everolimus and exemestane with exemestane and placebo in 724 patients (median age was 62 years) with hormone- receptor-positive advanced breast cancer who had recurrence or progression while receiving previous therapy with a non-steroidal aromatase inhibitor in the ...

Proliferation response to short-term endocrine therapy

Society for Endocrinology — Tue, 06 Dec 2011 12:00:00 +0100

Letrozole is an aromatase inhibitor used to treat ER-positive breast cancer. Bedard and colleagues used the gene expression grade index (GGI; a 97-gene algorithm that measures tumour proliferation and defines intermediate histological grade tumours as high- or low-grade) to determine clinical response to neoadjuvant letrozole. They found that women with low genomic grade tumours were more likely to respond to three months of letrozole treatment. GGI was a useful predictive biomarker of response to neoadjuvant anti-estrogen therapy in post-menopausal patients with ER-positive breast cancer. Bedard et al. (2011) Endocrine-Related Cancer 18 721–730. Read the full article at: DOI:10.1530/ERC-11-0180. (Source: Society for Endocrinology)

Researchers discover patterns of genes associated with timing of breast cancer recurrences

EurekAlert! - Cancer — Tue, 06 Dec 2011 05:00:00 +0100

(Georgetown University Medical Center) An international research team led by Georgetown Lombardi Comprehensive Cancer Center has found biological differences in hormone-receptor positive breast cancer that are linked to the timing of recurrence despite endocrine therapy.They say their findings, presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, may help oncologists find ways to individualize systemic therapy to delay or prevent recurrences, and to avoid excessive treatment of patients who will never recur. (Source: EurekAlert! - Cancer)

Impact of body mass index on compliance and persistence to adjuvant breast cancer therapy.

Breast — Mon, 05 Dec 2011 05:00:00 +0100

We present the first study which evaluates the impact of body mass index (BMI) on compliance (i.e. to start a recommended therapy) and persistence to adjuvant BC therapy. An unselected cohort of 766 patients (≤75 years) diagnosed from 1997 to 2009 was analyzed in relevance to the four adjuvant therapy modalities: (A) radiation, (B) chemotherapy, (C) therapy with trastuzumab, and (D) endocrine therapy. With respect to compliance, multivariate analyses calculated Odds ratios (ORs) >1 for increased BMI in all four therapy modalities, i.e. increased BMI had a positive influence on compliance. The results were significant for radiotherapy (OR,2.37;95%CI,1.45-3.88;p < 0.001) and endocrine therapy (OR,1.92;95%CI,1.21-3.04;p = 0.002) and showed a trend in chemotherapy (OR,1.42;95%CI,0....

Panhypopituitarism due to Wegener's granulomatosis

Arquivos Brasileiros de Endocrinologia e Metabologia — Sun, 04 Dec 2011 08:16:21 +0100

We present a female patient with WG who evolved with central diabetes insipidus (CDI), panhypopituitarism, and mild hyperprolactinemia. MRI showed an infiltrative pattern. Pituitary involvement has been reported in around 1% of patients with WG, mostly in women. It is represented by CDI and hypopituitarism. MRI generally shows pituitary enlargement, stalk thickening and loss of hyperintensity of the neurohypophysis. Permanent endocrine therapy is generally needed. WG should be considered in cases of CDI and hypopituitarism, essentially if a vasculitis is suspected and more common sellar disorders have been ruled out.A granulomatose de Wegener (GW) é uma vasculite necrotizante multissistêmica que afeta classicamente o trato respiratório superior, pulmões e rins. O envolvimento da hipóf...

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Prognostic factors for stage IV hormone receptor-positive primary metastatic breast cancer.

Breast Cancer — Sat, 03 Dec 2011 05:00:00 +0100

CONCLUSIONS: PgR positivity and clinical benefits of first-line ET were independent prognostic factors for patients with hormone receptor-positive stage IV breast cancer. Moreover, the benefits of second-line ET in patients with a tumor resistant to first-line ET suggests the existence of drug-specific resistance to ET. PMID: 22139727 [PubMed - as supplied by publisher] (Source: Breast Cancer)

Shorter disease-specific survival of ER-positive breast cancer patients with high cytoplasmic Src kinase expression after tamoxifen treatment

Journal of Cancer Research and Clinical Oncology — Thu, 01 Dec 2011 19:27:16 +0100

Conclusions No translational evidence was found in this study to support a role for Src kinase in developing de novo tamoxifen resistance. However, based on our findings on late clinical outcome, patients with high cytoplasmic c-Src may be selected for continuing endocrine therapy to prevent worsening prognosis. Content Type Journal ArticleCategory Original PaperPages 1-6DOI 10.1007/s00432-011-1096-8Authors B. Elsberger, Institute of Cancer, College of Medical, Veterinary and Life Sciences, University of Glasgow, Western Infirmary, McGregor Building, Dumbarton Road, Glasgow, G11 6NT UKD. M. Paravasthu, Institute of Cancer, College of Medical, Veterinary and Life Sciences, University of Glasgow, Western Infirmary, McGregor Building, Dumbarton Road, Glasgow, G11 6NT U...

Automated discovery of drug treatment patterns for endocrine therapy of breast cancer within an electronic medical record.

Journal of the American Medical Informatics Association — Thu, 01 Dec 2011 05:00:00 +0100

ConclusionWe present an algorithm for automated treatment classification within an electronic medical record to combine information extracted through natural language processing with that extracted from structured databases. The algorithm has high specificity for all categories, high sensitivity for five categories, and low sensitivity for two categories. PMID: 22140207 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association)

Luminal B breast cancer and novel therapeutic targets

Breast Cancer Research — Wed, 30 Nov 2011 05:00:00 +0100

Gene expression profiling has led to a new molecular classification of breast cancer characterized by four intrinsic subtypes: basal-like; erbB2/HER2-positive; luminal-A; and luminal-B. Despite expressing estrogen receptor, the luminal-B subtype confers increased risk of early relapse with endocrine therapy compared to luminal-A. Although luminal-B definitions vary, the hallmark appears to be increased expression of proliferation-related genes. Several biological pathways are identified as possible contributors to the poor outcomes and novel agents targeting these pathways are being developed with aims to improve survival. We review the definition of luminal-B breast cancer, its pathological and clinical features and potential targets for treatment. (Source: Breast Cancer Research)

Factors associated with concordant estrogen receptor expression at diagnosis and centralized re-assay in a Danish population-based breast cancer study.

Acta Oncologica — Wed, 30 Nov 2011 05:00:00 +0100

Conclusions. Several clinical factors were associated with ER assay concordance. Some women were ineffectively treated with tamoxifen, or required but did not receive tamoxifen. We observed almost exactly the protective effect of endocrine therapy among tamoxifen-treated ER + women whose tumors expressed the ER on re-assay, compared with those ER- on re-assay. Diagnostic pathology results for ER + tumors appear a valid and useful resource for research studies. However, those for ER- tumors have lower validity. Study-specific considerations regarding the aims, diagnostic period, and consequences of including ER- patients with truly ER + disease ought to be examined when using diagnostic pathology results for ER- tumors in research studies. PMID: 22129357 [PubMed - as supplied by publish...

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Women prefer adjuvant endocrine therapy to chemotherapy for breast cancer treatment.

Breast Cancer — Wed, 23 Nov 2011 05:00:00 +0100

CONCLUSION: Women prefer endocrine therapy to chemotherapy or trastuzumab therapy, given the same projected treatment benefits. Younger women prefer both chemotherapy and endocrine therapy as compared with older woman. PMID: 22109640 [PubMed - as supplied by publisher] (Source: Breast Cancer)

RhoC and guanine nucleotide exchange factor Net1 in androgen‐unresponsive mouse mammary carcinoma SC‐4 cells and human prostate cancer after short‐term endocrine therapy

The Prostate — Thu, 17 Nov 2011 15:57:26 +0100

CONCLUSIONSRho signaling is involved in the cell survival of SC‐4 cells. The higher expressions of RhoC and NET1 in human prostate cancers after short‐term endocrine therapy suggest that RhoC and NET1 may become therapeutic targets during endocrine therapy. Prostate © 2011 Wiley Periodicals, Inc. (Source: The Prostate)

Phosphatidylinositol 3-Kinase and Antiestrogen Resistance in Breast Cancer [BIOLOGY OF NEOPLASIA]

Journal of Clinical Oncology — Thu, 17 Nov 2011 05:00:00 +0100

Although antiestrogen therapies targeting estrogen receptor (ER) α signaling prevent disease recurrence in the majority of patients with hormone-dependent breast cancer, a significant fraction of patients exhibit de novo or acquired resistance. Currently, the only accepted mechanism linked with endocrine resistance is amplification or overexpression of the ERBB2 (human epidermal growth factor receptor 2 [HER2]) proto-oncogene. Experimental and clinical evidence suggests that hyperactivation of the phosphatidylinositol 3-kinase (PI3K) pathway, the most frequently mutated pathway in breast cancer, promotes antiestrogen resistance. PI3K is a major signaling hub downstream of HER2 and other receptor tyrosine kinases. PI3K activates several molecules involved in cell-cycle progression and...

Assessment of Ki67 in Breast Cancer: Recommendations from the International Ki67 in Breast Cancer Working Group

JNCI — Tue, 15 Nov 2011 05:00:00 +0100

Uncontrolled proliferation is a hallmark of cancer. In breast cancer, immunohistochemical assessment of the proportion of cells staining for the nuclear antigen Ki67 has become the most widely used method for comparing proliferation between tumor samples. Potential uses include prognosis, prediction of relative responsiveness or resistance to chemotherapy or endocrine therapy, estimation of residual risk in patients on standard therapy and as a dynamic biomarker of treatment efficacy in samples taken before, during, and after neoadjuvant therapy, particularly neoadjuvant endocrine therapy. Increasingly, Ki67 is measured in these scenarios for clinical research, including as a primary efficacy endpoint for clinical trials, and sometimes for clinical management. At present, the enormous vari...

Endocrine therapy in obese patients with primary breast cancer: another piece of evidence in an unfinished puzzle

Breast Cancer Research and Treatment — Sat, 12 Nov 2011 16:53:12 +0100

Abstract Obesity, defined as a body mass index (BMI) ≥30 is an independent risk factor in breast cancer and is correlated with shorter survival and enhanced recurrence rates. The present subgroup analysis of the German BRENDA-cohort aimed to investigate the correlation between BMI, recurrence-free survival (RFS) and adjuvant endocrine therapy. In this subgroup analysis, 4,636 patients were retrospectively examined using multivariate analyses. Overall 3,759 (81.1%) patients had a BMI <30 (non-obese) and 877 (18.9%) a BMI ≥30 (obese). In the group of all 3,896 (84.0%) patients with hormone-receptor-positive (HR+) breast carcinomas a significant reduction in RFS was demonstrated for those who were obese (P = 0.002; HR = 1.45 (95% CI: 1.15–1.83)), a...

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The EORTC 10041/BIG 03-04 MINDACT trial is feasible: Results of the pilot phase

European Journal of Cancer — Thu, 03 Nov 2011 04:00:00 +0100

Conclusions: The logistically complex MINDACT trial is feasible in a multinational setting. The proportion of discordant patients, the potential reduction in CT by using the genomic signature and compliance to treatment assignment are in accordance with the trial hypotheses. (Source: European Journal of Cancer)

How do I Treat “Triple-Negative” Disease

Current Treatment Options in Oncology — Wed, 02 Nov 2011 16:57:59 +0100

Opinion statement Over the recent years, there has been an increasing recognition that triple-negative breast cancer constitutes a separate, albeit heterogeneous, entity arising from distinct oncogenic pathways. Despite its aggressive clinical behavior, triple-negative disease responds favorably to cytotoxic chemotherapy resulting in high response rates. Nonetheless, the relapse rates are high and, in the absence of targeted therapies to significantly alter its natural history, the prognosis can be poor. Most of the trials conducted in the past that led to the formulation of the current guidelines have indiscriminately lumped triple-negative disease with receptor-positive subtypes. Therefore, there are relatively scant data regarding how standard approaches specifically ap...

[Menopausal symptoms and their treatment emerging during hormonal therapy of breast cancer].

Magyar Onkologia — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Rubovszky G, Horváth Z Abstract Hormonal compounds play an important role in the treatment of breast cancer. Their side effects may lead to suspension of therapy and consequently to the failure of the expected effect. Common and the same way most prevalent side effects of hormonal compounds are the menopausal complaints which can alter quality of life significantly. The early recognition and treatment of menopausal complaints and symptoms help to reach therapeutic success. In general, of menopausal related complaints the role of hot flash, atrophic vaginitis and sexual dysfunction is emphasized. Within the topic, it is possible to mention some musculo-skeletal complaints according to their similar etiology, the failure of estrogen effect. In the treatment of hot flash non...

Genomics of adjuvant therapy for breast cancer.

Cancer Journal — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Kim SR, Paik S Abstract ABSTRACT: Therapeutic decision for adjuvant systemic therapy for breast cancer involves assessment of baseline risk and estimated benefit from systemic therapy. Molecular profiling studies have clearly demonstrated heterogeneity of chemotherapy response across different molecular subtypes of breast cancer. Meta-analyses of publicly available data from gene expression profiling studies have demonstrated that breast cancer can be divided into 4 basic categories based on expression levels of estrogen receptor (ER), HER2, and proliferation-associated genes; ER-, HER2+, ER+/HER2-/low proliferation, and ER+/HER2-/high proliferation. Notably ER- or HER2+ tumors are associated with high levels expression of proliferation genes, although there is a wide spec...

BRCA Mutation Testing in Determining Breast Cancer Therapy.

Cancer Journal — Tue, 01 Nov 2011 04:00:00 +0100

This article reviews surgical options for management of affected BRCA mutation carriers with emphasis on the risks of ipsilateral recurrence and contralateral breast cancer. The roles of breast-conserving surgery, prophylactic mastectomy, and oophorectomy are reviewed. In addition, the sensitivity of BRCA mutation-associated breast cancer to endocrine therapy, platinum chemotherapy, and poly (ADP-ribose) polymerase inhibitors is reviewed. PMID: 22157293 [PubMed - in process] (Source: Cancer Journal)

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Aromatase Inhibitors as Solely Treatment in Postmenopausal Breast Cancer Patients

The Breast Journal — Tue, 01 Nov 2011 04:00:00 +0100

We report our experience with aromatase inhibitors as primary endocrine therapy for estrogen receptor positive breast cancer in postmenopausal woman who are impaired by other diseases, refuse surgery or are of old age. Fifty‐six patients with fifty‐seven ER+ operable breast cancers who refused surgery, were judged ineligible for surgery because of comorbidity, or were of old age were treated with endocrine therapy using aromatase inhibitors only. Digital mammography and high‐end breast ultrasound were used to assess tumor sizes. The mean age of the patients was 74 years (range 52–102 years). All patients suffered from breast cancer. The mean follow‐up interval was 40 months (range 5–92 months). Seven patients (12%) achieved complete clinical remission, 31 (57%) partial ...

[Articles] Assessment of letrozole and tamoxifen alone and in sequence for postmenopausal women with steroid hormone receptor-positive breast cancer: the BIG 1-98 randomised clinical trial at 8·1 years median follow-up

The Lancet Oncology — Mon, 31 Oct 2011 00:30:04 +0100

We present an update of efficacy outcomes in the Breast International Group (BIG) 1-98 study at 8·1 years median follow-up.MethodsBIG 1-98 is a randomised, phase 3, double-blind trial of postmenopausal women with hormone receptor-positive early breast cancer that compares 5 years of tamoxifen or letrozole monotherapy, or sequential treatment with 2 years of one of these drugs followed by 3 years of the other. (Source: The Lancet Oncology)

A Kinome-Wide Screen Identifies the Insulin/IGF-I Receptor Pathway as a Mechanism of Escape from Hormone Dependence in Breast Cancer

Cancer Research — Sun, 30 Oct 2011 04:00:00 +0100

In this study, we sought to identify kinases essential for growth of ER+ breast cancer cells resistant to long-term estrogen deprivation (LTED). A kinome-wide siRNA screen showed that the insulin receptor (InsR) is required for growth of MCF-7/LTED cells. Knockdown of InsR and/or insulin-like growth factor-I receptor (IGF-IR) inhibited growth of 3 of 4 LTED cell lines. Inhibition of InsR and IGF-IR with the dual tyrosine kinase inhibitor OSI-906 prevented the emergence of hormone-independent cells and tumors in vivo, inhibited parental and LTED cell growth and PI3K/AKT signaling, and suppressed growth of established MCF-7 xenografts in ovariectomized mice, whereas treatment with the neutralizing IGF-IR monoclonal antibody MAB391 was ineffective. Combined treatment with OSI-906 and the ER d...

Eligibility, Compliance and Persistence of Sequential Therapy with Aromatase Inhibitors following 2-3 Years of Tamoxifen in Endocrine Adjuvant Breast Cancer Therapy.

Oncology — Tue, 25 Oct 2011 04:00:00 +0100

Conclusions: Only a minority of the patients who started an endocrine adjuvant BC therapy was eligible for sequential therapy. Patients who underwent a switch had a high rate of persistence. Efforts should be made to make sure that all physicians, above all general practitioners, who are involved in the treatment of BC patients, are provided with current therapy guidelines. PMID: 22041855 [PubMed - as supplied by publisher] (Source: Oncology)

Use of Tamoxifen Before and During Pregnancy.

The Oncologist — Fri, 21 Oct 2011 04:00:00 +0100

Authors: Braems G, Denys H, De Wever O, Cocquyt V, Van den Broecke R Abstract AbstractFor premenopausal patients with receptor-positive early breast cancer, administration of tamoxifen for 5 years constitutes the main adjuvant endocrine therapy. During pregnancy, tamoxifen and its metabolites interact with rapidly growing and developing embryonic or fetal tissues.Information about tamoxifen and pregnancy was gathered by searching PubMed. In addition, we had access to the records of the pharmaceutical company AstraZeneca. Because these observations are retrospective and other therapies and diagnostic measures are possible confounders, a causal relationship was not established between tamoxifen treatment and pregnancy outcome.The records from AstraZeneca documented three live births ...

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Current and emerging targeted therapies for metastatic breast cancer

Cancer — Mon, 17 Oct 2011 04:00:00 +0100

AbstractThe success of endocrine therapies for hormone receptor‐positive breast cancer and trastuzumab and lapatinib for targeting human epidermal growth factor receptor 2 (HER2)‐positive tumors has paved the way for the clinical development of several other metastatic breast cancer (MBC)‐targeted therapies. Although the benefit of the anti‐VEGF (vascular endothelial growth factor) monoclonal antibody bevacizumab in the MBC setting has become a topic of debate, clinical trial results are accumulating, and phase 3 evaluations are ongoing for newer HER2‐targeted agents (pertuzumab and trastuzumab‐maytansine immunoconjugate) and VEGF‐targeted agents (aflibercept), as well as dual, epidermal growth factor receptor/HER2‐targeted agents (afatinib [BIBW 2992] and neratinib), multi...

Modeling of response to endocrine therapy in a panel of human luminal breast cancer xenografts

Breast Cancer Research and Treatment — Sat, 15 Oct 2011 15:46:29 +0100

Abstract Resistance to endocrine therapy is a major complication of luminal breast cancer and studies of the biological features of hormonal resistance are limited by the lack of adequate preclinical models. The aim of this study is to establish and characterize a panel of primary human luminal breast carcinoma xenografts, and to evaluate their response to endocrine therapies. Four hundred and twenty-three tumor fragments obtained directly from patients have been grafted in the interscapular fatpad of Swiss nude mice. After stable engraftment with estradiol supplementation, xenografted tumors have been validated by conventional pathology and immunohistochemistry examination, and additional molecular studies. In vivo tumor growth and response to different endocrine treatmen...

Cost-Benefit Analysis of Endocrine Therapy in the Adjuvant Setting for Postmenopausal Patients with Hormone Receptor-Positive Breast Cancer, Based on Survival Data and Future Prices for Generic Drugs in the Context of the German Health Care System

Breast Care : Last 20 articles — Wed, 12 Oct 2011 23:00:00 +0100

Breast Care 2011;6:381–389 (DOI:10.1159/000333118) (Source: Breast Care : Last 20 articles)

Eligibility, compliance and persistence of extended adjuvant endocrine therapy for breast cancer.

Acta Oncologica — Mon, 10 Oct 2011 04:00:00 +0100

Conclusions. Only a minority of the patients who started an endocrine therapy were actually eligible for an ET. Patients who were offered/recommended an ET had a high rate of compliance and persistence. Efforts should be made to make sure that all physicians, above all general practitioners, who are involved in the treatment of BC patients, are provided with current therapy guidelines as to guarantee an optimal patient management. PMID: 21985132 [PubMed - as supplied by publisher] (Source: Acta Oncologica)

ASTRO: Neoadjuvant Endocrine Tx Viable in ER Positive Cancer (CME/CE)

MedPage Today Hematology/Oncology — Sun, 09 Oct 2011 03:13:05 +0100

MIAMI BEACH (MedPage Today) -- Neoadjuvant endocrine therapy is a potential alternative to pre-surgery cytotoxic chemotherapy in patients with locally advanced estrogen receptor-positive breast cancer, a single-center study suggested. (Source: MedPage Today Hematology/Oncology)

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Compliance and persistence of endocrine adjuvant breast cancer therapy

Breast Cancer Research and Treatment — Thu, 06 Oct 2011 05:50:17 +0100

This study evaluates compliance and persistence in adjuvant endocrine breast cancer (BC) therapy by clearly analyzing reasons of therapy cessation by differentiating clinical meaningful situations. In order to illuminate the complex field of personal motivation to therapy, a single institution study with a more individual-based approach might better be suited to provide a detailed case documentation than the more epidemiologic approach of large database studies. An unselected cohort of 698 patients (≤80 years) diagnosed with hormonal receptor-positive BC from 1997 to 2008 at the University Hospital Basel, Switzerland, was analyzed. The term “non-persistence” was exclusively used for patients where the discontinuation of endocrine therapy (ET) could have been modified by mo...

[Correspondence] Zoledronic acid in early-stage breast cancer

The Lancet Oncology — Sat, 01 Oct 2011 04:00:00 +0100

Michael Gnant and co-workers reported an update of the ABCSG-12 randomised trial of adjuvant endocrine therapy plus zoledronic acid in premenopausal women with early-stage breast cancer. At a median follow-up of 62 months, addition of zoledronic acid improved disease-free survival in patients taking anastrozole or tamoxifen. Although zoledronic acid did not significantly affect risk of death, these data suggest an antitumour activity of zoledronic acid. (Source: The Lancet Oncology)

[Correspondence] Adjuvant zoledronic acid for breast cancer: mechanism of action?

The Lancet Oncology — Sat, 01 Oct 2011 04:00:00 +0100

The ABCSG-12 trial reported a sustained disease-free survival (DFS) benefit of endocrine therapy plus zoledronic acid in premenopausal women with early-stage breast cancer. Taken together with two other trials of zoledronic acid in premenopausal and postmenopausal patients with breast cancer (webappendix p 1), this trial raises important questions about which patients might benefit most from adjuvant treatment. (Source: The Lancet Oncology)

Simultaneous Inhibition of Estrogen Receptor and the HER2 Pathway in Breast Cancer: Effects of HER2 Abundance.

Translational Oncology — Sat, 01 Oct 2011 04:00:00 +0100

Authors: Emde A, Mahlknecht G, Maslak K, Ribba B, Sela M, Possinger K, Yarden Y Abstract The estrogen receptor (ER) pathway and the epidermal growth factor receptor (EGFR) pathway play pivotal roles in breast cancer progression. Targeted therapies able to intercept ER or signaling downstream to EGFR and its kin, HER2, are routinely used to treat distinct groups of breast cancer patients. However, patient responses are limited by resistance to endocrine therapy, which may be due to compensatory HER2/EGFR signaling. This raises the possibility that simultaneous interception of HER2 and ER may enhance therapeutic efficacy. To address the question, we treated breast cancer cells with both fulvestrant (ICI 182780), an ER antagonist with no agonist effects, and lapatinib, an orally avail...

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Bone health management in patients with breast cancer: Current standards and emerging strategies

The Breast — Wed, 28 Sep 2011 04:00:00 +0100

Abstract: In women who develop bone metastases from breast cancer (BC), interactions between tumor cells and osteoclasts within the bone lead to localized bone destruction and increase the risk of skeletal-related events (SREs). Bisphosphonates inhibit osteoclast-mediated bone resorption, and have been used extensively for treating post-menopausal osteoporosis and reducing the risk of SREs in patients with bone metastases. A number of clinical trials in women with early stage BC have demonstrated that adding bisphosphonates to adjuvant endocrine therapy can prevent bone loss and may prevent disease recurrence and improve disease-free survival. In women with bone metastases from BC, bisphosphonates have demonstrated efficacy for reducing skeletal morbidity and pain and improving quality of ...

Bone health management in patients with breast cancer: Current standards and emerging strategies.

Breast — Tue, 27 Sep 2011 04:00:00 +0100

Authors: Aapro MS, Coleman RE Abstract In women who develop bone metastases from breast cancer (BC), interactions between tumor cells and osteoclasts within the bone lead to localized bone destruction and increase the risk of skeletal-related events (SREs). Bisphosphonates inhibit osteoclast-mediated bone resorption, and have been used extensively for treating post-menopausal osteoporosis and reducing the risk of SREs in patients with bone metastases. A number of clinical trials in women with early stage BC have demonstrated that adding bisphosphonates to adjuvant endocrine therapy can prevent bone loss and may prevent disease recurrence and improve disease-free survival. In women with bone metastases from BC, bisphosphonates have demonstrated efficacy for reducing skeletal morbidi...

Progress in endocrine approaches to the treatment and prevention of breast cancer

Maturitas — Mon, 26 Sep 2011 04:00:00 +0100

Abstract: Tamoxifen had been the only available hormonal option for the systemic treatment for breast cancer from 1973 to 2000. Enormous efforts have led to the development of potent and selective third generation aromatase inhibitors including anastrozole, letrozole and exemestane. Due to their superior efficacy to tamoxifen, aromatase inhibitors are presently approved as first line agents for the treatment of advanced estrogen receptor (ER) positive breast cancer and adjuvant therapy in early ER positive early breast cancer in postmenopausal women. Selective ER Modulators (SERMS), tamoxifen and raloxifene are the only agents presently used in breast cancer prevention in high risk women and their use has increased substantially over the last decade. Third generations SERMS, lasofoxifene a...

Long-term results of International Breast Cancer Study Group Trial VIII: adjuvant chemotherapy plus goserelin compared with either therapy alone for premenopausal patients with node-negative breast cancer

Annals of Oncology — Fri, 23 Sep 2011 04:00:00 +0100

Conclusions: For pre/perimenopausal women with lymph-node-negative ER-positive breast cancer, CMF followed by goserelin improved DFS in comparison with either modality alone. The improvement was the most pronounced in those aged below 40, suggesting an endocrine effect of prolonged CMF-induced amenorrhea. (Source: Annals of Oncology)

A new gene expression signature, the ClinicoMolecular Triad Classification, may improve prediction and prognostication of breast cancer at the time of diagnosis

Breast Cancer Research — Thu, 22 Sep 2011 04:00:00 +0100

Conclusions: CMTC correlates well with current clinical classification of BCs and has the potential to be easily integrated into routine clinical practice readily. Using FNABs, CMTC can be determined at the time of diagnostic needle biopsies for tumors of all sizes. Using the public databases as the validation cohort in our analyses, CMTC appeared to be able to provide treatment guidance more accurately, could be available in preoperative settings and applicable to all BC types independent of size, receptor and nodal status. The unique oncogenic signaling pathway pattern of each CMTC group may provide guidance to new treatment strategies. Further validation of CMTC will required prospective randomized controlled trials. (Source: Breast Cancer Research)

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Mortality Rates Among Early-Stage Hormone Receptor-Positive Breast Cancer Patients: A Population-Based Cohort Study in Denmark

JNCI — Tue, 20 Sep 2011 04:00:00 +0100

Conclusions A small subgroup of breast cancer patients who were 60 years or older and had hormone-responsive early-stage tumors up to 10 mm, and received no systemic adjuvant therapy, were not at increased risk of mortality compared with women in this age-group in the general population. (Source: JNCI)

Clinical relevance of withdrawal therapy as a form of hormonal manipulation for breast cancer

World Journal of Surgical Oncology — Fri, 09 Sep 2011 04:00:00 +0100

Conclusion: Withdrawal therapy appears to produce sustained CB in a significant proportion of patients. This applies not only to withdrawal from tamoxifen, but also from other categories of endocrine agents. Withdrawal from endocrine therapy is, therefore, a viable intercalating option between endocrine agents to minimise resistance and provide additional line of therapy. It should be considered as part of the sequencing of endocrine therapy. (Source: World Journal of Surgical Oncology)

Adjuvant Endocrine Therapy for Breast Cancer: Don't Ditch the Switch!

JNCI — Thu, 08 Sep 2011 04:00:00 +0100

(Source: JNCI)

Toxicity of Adjuvant Endocrine Therapy in Postmenopausal Breast Cancer Patients: A Systematic Review and Meta-analysis

JNCI — Thu, 08 Sep 2011 04:00:00 +0100

Conclusions The cumulative toxicity of aromatase inhibitors when used as up-front treatment may explain the lack of overall survival benefit despite improvements in disease-free survival. Switching from tamoxifen to aromatase inhibitors reduces this toxicity and is likely the best balance between efficacy and toxicity. (Source: JNCI)

A phase 2 trial of dasatinib in patients with advanced HER2-positive and/or hormone receptor-positive breast cancer.

Clinical Cancer Research — Thu, 08 Sep 2011 04:00:00 +0100

CONCLUSIONS: Limited single-agent activity was observed with dasatinib in patients with advanced HR+ breast cancer. PMID: 21903773 [PubMed - as supplied by publisher] (Source: Clinical Cancer Research)

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Menopausal State in Breast Cancer: How Reliable is the Data?

Clinical Breast Cancer — Tue, 06 Sep 2011 04:00:00 +0100

CONCLUSION: Despite the high importance of the menopausal state for the management of BC, above all, when planning antihormonal adjuvant therapy, the menopausal state was unable to be defined at the time of BC diagnosis in a significant proportion of women. The dilemma that menopause cannot be assessed in some BC cases is increasingly being recognized. Close cooperation between oncologists and endocrinologists is desirable to establish an optimal, individually tailored therapy for women with an unclear menopausal state due to hormonal therapies, hysterectomy, or chemotherapy. PMID: 21903481 [PubMed - as supplied by publisher] (Source: Clinical Breast Cancer)

[Clinicopathological characteristics of male breast cancer: analysis of 25 cases at a single institution].

Journal of Southern Medical University — Thu, 01 Sep 2011 04:00:00 +0100

CONCLUSION: The 5-year survival rate was 66.5% in these male breast cancer patients. Neoadjuvant chemotherapy, tumor size, lymph node status, distant metastasis and TNM stage are significant predictors of the overall patient survival. PMID: 21945746 [PubMed - in process] (Source: Journal of Southern Medical University)

Hormonal Modulation in the Treatment of Breast Cancer

Endocrinology and Metabolism Clinics of North America — Wed, 31 Aug 2011 23:00:00 +0100

This article explores the history of endocrine therapy for the treatment of breast cancer, the clinical evidence behind the current standards of care, and controversies that may change these standards in the future. (Source: Endocrinology and Metabolism Clinics of North America)

Management of Bone Disease in Patients Undergoing Hormonal Therapy for Breast Cancer

Endocrinology and Metabolism Clinics of North America — Wed, 31 Aug 2011 23:00:00 +0100

This article reviews the effect of endocrine therapies of breast cancer on bone and the management of bone disease with these endocrine therapies. The effect of these therapies on bone mineral density and bone turnover along with possible interventions is discussed. AIs are also associated with skeletal-related events, which are not discussed. (Source: Endocrinology and Metabolism Clinics of North America)

Effects of SDF-1-CXCR4 signaling on microRNA expression and tumorigenesis in estrogen receptor-alpha (ER-α)-positive breast cancer cells.

Experimental Cell Research — Tue, 30 Aug 2011 04:00:00 +0100

Authors: Rhodes LV, Bratton MR, Zhu Y, Tilghman SL, Muir SE, Salvo VA, Tate CR, Elliott S, Nephew KP, Collins-Burow BM, Burow ME Abstract The majority of breast cancer cases ultimately become unresponsive to endocrine therapies, and this progression of breast cancer from hormone-responsive to hormone-independent represents an area in need of further research. Additionally, hormone-independent carcinomas are characterized as being more aggressive and metastatic, key features of more advanced disease. Having previously shown the ability of the stromal-cell derived factor-1 (SDF-1)-CXCR4 signaling axis to promote primary tumorigenesis and hormone independence by overexpressing CXCR4 in MCF-7 cells, in this study we further examined the role of SDF-1/CXCR4 in the endogenously CXCR4-pos...

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Tissue composition of mammographically dense and non-dense breast tissue

Breast Cancer Research and Treatment — Mon, 29 Aug 2011 15:58:34 +0100

Abstract Mammographic density is a strong risk factor for breast cancer but its underlying biology in healthy women is not well-defined. Using a novel collection of core biopsies from mammographically dense versus non-dense regions of the breasts of healthy women, we examined histologic and molecular differences between these two tissue types. Eligible participants were 40 + years, had a screening mammogram and no prior breast cancer or current endocrine therapy. Mammograms were used to identify dense and non-dense regions and ultrasound-guided core biopsies were performed to obtain tissue from these regions. Quantitative assessment of epithelium, stroma, and fat was performed on dense and non-dense cores. Molecular markers including Ki-67, estrogen receptor (ER)...

Invasive lobular carcinoma: response to neoadjuvant letrozole therapy

Breast Cancer Research and Treatment — Thu, 25 Aug 2011 15:51:39 +0100

We examined the effectiveness of neoadjuvant letrozole in postmenopausal women (PMW) with estrogen receptor (ER)-rich ILC. PMW were considered for treatment with neoadjuvant letrozole if they had ER-rich, large operable, or locally advanced cancers, or were unfit for surgical therapy. Tumor volume was estimated at diagnosis and at 3 months using calipers (clinical), ultrasound, and mammography. At 3 months, if physically fit, women were assessed for surgery. Responsive women with cancers too large for breast-conserving surgery continued with letrozole. Patients had surgery or were switched to alternative therapy if tumor volume was increasing. Sixty-one patients (mean age, 76.2 years) with 63 ILCs were treated with letrozole for ≥3 months. The mean reduction in ...

Alteration of Y-box binding protein-1 expression modifies the response to endocrine therapy in estrogen receptor-positive breast cancer

Breast Cancer Research and Treatment — Tue, 23 Aug 2011 15:53:03 +0100

This study examined whether YB-1 is involved in the alteration of response to endocrine therapy in estrogen receptor (ER)-positive breast cancer cells. MCF7 cells that stably expressed YB-1 (MCF7-YB-1) and vector control cells (MCF7-vector) were established. These cells were used to analyze the expression of the factors related to ER and growth factor receptor signaling pathways and responses to antiestrogens (tamoxifen and fulvestrant) and estrogen responsive element (ERE) activity. The effect of knocking down endogenous YB-1 expression was tested in wild-type MCF7 cells. In addition, the expression of YB-1 and the factors related to ER and growth factor receptor signaling pathways were evaluated in clinical breast cancers treated with preoperative chemotherapy. The expression of H...

Aromatase Therapy Timing Key in Breast Cancer Survival (CME/CE)

MedPage Today OB/GYN — Tue, 23 Aug 2011 15:09:40 +0100

(MedPage Today) -- Breast cancer patients treated with endocrine therapy might improve their odds for survival by starting with tamoxifen and then switching to an aromatase inhibitor, authors of a meta-analysis concluded. (Source: MedPage Today OB/GYN)

Relationship between body mass index and preoperative treatment response to aromatase inhibitor exemestane in postmenopausal patients with primary breast cancer

The Breast — Mon, 22 Aug 2011 04:00:00 +0100

Abstract: Background: Some studies have shown that high body mass index (BMI) is associated with inferior outcome after adjuvant therapy with anastrozole in breast cancer patients. We aimed to investigate predictive effect of BMI on clinical response to neoadjuvant therapy with exemestane in postmenopausal patients with primary breast cancer.Patients and methods: The study group consisted of 109 patients from the JFMC 34-0601 neoadjuvant endocrine therapy trial. Patients were categorized into three groups according to BMI: low (BMI (Source: The Breast)

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Relationship between body mass index and preoperative treatment response to aromatase inhibitor exemestane in postmenopausal patients with primary breast cancer.

Breast — Wed, 17 Aug 2011 23:00:00 +0100

CONCLUSION: Low BMI was associated with a decreased ORR to neoadjuvant endocrine therapy with exemestane. Our results may suggest that the predictive effect of BMI varies according to the type of aromatase inhibitor and objective outcome. PMID: 21855342 [PubMed - as supplied by publisher] (Source: Breast)

Outcome of long term active surveillance for estrogen receptor-positive ductal carcinoma in situ

The Breast — Tue, 16 Aug 2011 04:00:00 +0100

Conclusion: Long-term active surveillance for DCIS is feasible in a well-informed patient population, but is associated with risk of invasive cancer at surgical excision. (Source: The Breast)

Estrogen receptor degradation: a CUE for endocrine resistance?

Breast Cancer Research — Mon, 15 Aug 2011 23:00:00 +0100

Despite the undoubted success of adjuvant endocrine therapies that target the estrogen receptor pathway, not all women with estrogen receptor-positive breast cancer respond to these therapies, and many who initially respond will subsequently relapse. Deregulation of various aspects of estrogen receptor signaling has been highlighted as a mechanism of resistance and as a basis for alternative therapeutic approaches. However, a recent publication refocuses attention on the estrogen receptor itself by showing that the ubiquitin-binding CUE domain-containing protein 2 is a regulator of estrogen receptor protein degradation and a marker of endocrine resistance in breast cancer. (Source: Breast Cancer Research)

Outcome of long term active surveillance for estrogen receptor-positive ductal carcinoma in situ.

Breast — Fri, 12 Aug 2011 23:00:00 +0100

CONCLUSION: Long-term active surveillance for DCIS is feasible in a well-informed patient population, but is associated with risk of invasive cancer at surgical excision. PMID: 21843942 [PubMed - as supplied by publisher] (Source: Breast)

Impact of low estrogen/progesterone receptor expression on survival outcomes in breast cancers previously classified as triple negative breast cancers

Cancer — Fri, 12 Aug 2011 14:53:30 +0100

CONCLUSIONS:In this cohort, a low ER/PR level (1%‐5%) does not appear to have any significant impact on survival outcomes. There was a tendency for survival advantages in the ER/PR 6% to 10% is seen. Benefit of endocrine therapy in these patients is unclear. Cancer 2011;. © 2011 American Cancer Society. (Source: Cancer)

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Similarities and differences in the characteristics and primary treatment of breast cancer in men and women - a population based study (Sweden).

Acta Oncologica — Wed, 10 Aug 2011 23:00:00 +0100

Conclusion. Concerns regarding less extensive treatment in MBC patients were not supported by this study. Although no differences in the stage of the disease or treatment intensity could be demonstrated, outcome was inferior in the male group. PMID: 21830994 [PubMed - as supplied by publisher] (Source: Acta Oncologica)

Psychotropic medication during endocrine treatment for breast cancer

Supportive Care in Cancer — Sat, 06 Aug 2011 05:45:43 +0100

Conclusions This study indicated increased psychological distress due to breast cancer diagnosis and/or treatment in women on endocrine therapy. Anti-depressants were only prescribed for a short time. These data can contribute to an improved awareness of the impact of breast cancer (treatment) and therefore potentially to the optimizing of support for these patients. Content Type Journal ArticlePages 1-8DOI 10.1007/s00520-011-1242-5Authors Geertruida H. de Bock, Department of Epidemiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The NetherlandsRegina F. Musters, Unit of PharmacoEpidemiology and PharmacoEconomics, Department of Pharmacy, University of Groningen, Groningen, The NetherlandsH. Jens Bos, Unit of Pha...

Differential regulation of endogenous pro-inflammatory cytokine genes by medroxyprogesterone acetate and norethisterone acetate in cell lines of the female genital tract

Contraception — Fri, 05 Aug 2011 04:00:00 +0100

Conclusion: Collectively, these data demonstrate that cell lines from different anatomical sites of the female genital tract respond differently to Prog and the synthetic progestins, most likely due to differential actions via different steroid receptors. The results highlight the importance of choice of progestins for immune function in the cervicovaginal environment. They further suggest that choice of progestins in endocrine therapy may have implications for women's risk of susceptibility to infections due to differential actions on genes involved in inflammation and immune function. (Source: Contraception)

Breast Cancer Medications and Vision: Effects of Treatments for Early-stage Disease.

Current Eye Research — Thu, 04 Aug 2011 23:00:00 +0100

Authors: Eisner A, Luoh SW This review concerns the visual and ocular effects of medications prescribed at three phases of treatment for women with early-stage breast cancer (BC): (1) adjuvant cytotoxic chemotherapy, (2) adjuvant endocrine therapy, and (3) symptomatic relief. The most common side effects of cytotoxic chemotherapy are epiphora and ocular surface irritation, which can be caused by any of several different regimens. Most notably, the taxane docetaxel can lead to epiphora by inducing canalicular stenosis. The selective-estrogen-receptor-modulator (SERM) tamoxifen, long the gold-standard adjuvant-endocrine-therapy for women with hormone-receptor-positive BC, increases the risk of posterior subcapsular cataract. Tamoxifen also affects the optic nerve head more often than pre...

A diagnostic gene profile for molecular subtyping of breast cancer associated with treatment response

Breast Cancer Research and Treatment — Thu, 04 Aug 2011 15:22:30 +0100

Abstract Classification of breast cancer into molecular subtypes maybe important for the proper selection of therapy, as tumors with seemingly similar histopathological features can have strikingly different clinical outcomes. Herein, we report the development of a molecular subtyping profile (BluePrint), that enables rationalization in patient selection for either chemotherapy or endocrine therapy prescription. An 80-Gene Molecular Subtyping Profile (BluePrint) was developed using 200 breast cancer patient specimens and confirmed on four independent validation cohorts (n = 784). Additionally, the profile was tested as a predictor of chemotherapy response in 133 breast cancer patients, treated with T/FAC neoadjuvant chemotherapy. BluePrint classification of a pat...

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A new molecular predictor of distant recurrence in ER-positive, HER2-negative breast cancer adds independent information to conventional clinical risk factors.

Clinical Cancer Research — Sun, 31 Jul 2011 23:00:00 +0100

CONCLUSIONS: The multigene EP risk score provided additional prognostic information to the risk of distant recurrence of breast cancer patients, independent from clinicopathological parameters. The EPclin score outperformed all conventional clinicopathological risk factors. PMID: 21807638 [PubMed - as supplied by publisher] (Source: Clinical Cancer Research)

[Exclusive radiotherapy and concurrent endocrine therapy for the management of elderly breast cancer patients: Case study and review of hypofractionated schemes.]

Cancer Radiotherapie — Wed, 27 Jul 2011 23:00:00 +0100

We report a case of a patient treated with exclusive endocrine and radiotherapy and address the state of the art on hypofractionated schemes for the management of elderly breast cancer patients. While hypofractionated radiotherapy does not compromise the oncologic or cosmetic outcome, there is no prospective data that assesses the place of radiotherapy for the exclusive treatment of elderly patients. This strategy should be further assessed in clinical randomized trial. PMID: 21802971 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)

Strategies for subtypes--dealing with the diversity of breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011

Annals of Oncology — Tue, 26 Jul 2011 23:00:00 +0100

The 12th St Gallen International Breast Cancer Conference (2011) Expert Panel adopted a new approach to the classification of patients for therapeutic purposes based on the recognition of intrinsic biological subtypes within the breast cancer spectrum. For practical purposes, these subtypes may be approximated using clinicopathological rather than gene expression array criteria. In general, systemic therapy recommendations follow the subtype classification. Thus, ‘Luminal A’ disease generally requires only endocrine therapy, which also forms part of the treatment of the ‘Luminal B’ subtype. Chemotherapy is considered indicated for most patients with ‘Luminal B', ‘Human Epidermal growth factor Receptor 2 (HER2) positive’, and ‘Triple negative ...

A phase II neoadjuvant trial of anastrozole, fulvestrant, and gefitinib in patients with newly diagnosed estrogen receptor positive breast cancer

Breast Cancer Research and Treatment — Tue, 26 Jul 2011 15:47:34 +0100

Abstract Endocrine therapy in patients with breast cancer can be limited by the problem of resistance. Preclinical studies suggest that complete blockade of the estrogen receptor (ER) combined with inhibition of the epidermal growth factor receptor can overcome endocrine resistance. We tested this hypothesis in a phase II neoadjuvant trial of anastrozole and fulvestrant combined with gefitinib in postmenopausal women with newly diagnosed ER-positive breast cancer. After a baseline tumor core biopsy, patients were randomized to receive anastrozole and fulvestrant or anastrozole, fulvestrant, and gefitinib (AFG) for 3 weeks. After a second biopsy at 3 weeks, all patients received AFG for 4 months and surgery was done if the tumor was operable. The primary endp...

Mechanisms of FGFR3 actions in endocrine resistant breast cancer

International Journal of Cancer — Sun, 24 Jul 2011 23:00:00 +0100

AbstractAlthough endocrine therapy has dramatically improved the treatment of breast cancer therapeutic resistance and tumour recurrence occurs, even in estrogen receptor (ER) positive cases. Identifying and understanding the molecular mechanisms which underpin endocrine resistance is therefore important if future therapeutic strategies are to be developed. Members of the fibroblast growth factor (FGF) and fibroblast growth factor receptor (FGFRs) families have been implicated in breast cancer development and progression. Our results demonstrate that culture of MCF7 cells with FGF1 results in reduced sensitivity to tamoxifen in vitro. Furthermore, our tissue microarray expression data demonstrates that FGFR3 expression is increased in tamoxifen resistant breast tumours. To confirm that act...

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Caring for survivors of breast cancer: perspective of the primary care physician

Current Oncology — Wed, 20 Jul 2011 13:53:53 +0100

ConclusionsPrimary care physicians who provide follow-up for survivors of breast cancer report that they are confident in managing care and satisfied with discharge letters containing a diagnosis and treatment summary, and recommendations for surveillance and endocrine treatment. At the time of patient discharge, additional information about common medical and psychosocial issues in this patient population would be useful to primary care physicians. Preferred means to access current breast cancer information include continuing medical education events and online resources. (Source: Current Oncology)

Fluoroestradiol positron emission tomography reveals differences in pharmacodynamics of aromatase inhibitors, tamoxifen, and fulvestrant in patients with metastatic breast cancer.

Clinical Cancer Research — Thu, 14 Jul 2011 23:00:00 +0100

Authors: Linden HM, Kurland BF, Peterson LM, Schubert EK, Gralow JR, Specht JM, Ellis GK, Lawton TJ, Livingston RB, Petra PH, Link JM, Krohn KA, Mankoff DA To determine, by molecular imaging, how in vivo pharmacodynamics of estrogen-estrogen receptor (ER) binding differ between types of standard endocrine therapy. PMID: 21750198 [PubMed - in process] (Source: Clinical Cancer Research)

Distinct expressions of microRNAs that directly target estrogen receptor α in human breast cancer

Breast Cancer Research and Treatment — Thu, 14 Jul 2011 06:01:34 +0100

In this study, expression levels of miRNAs that directly target ERα, including miR-18a, miR-18b, miR-22, miR-193b, miR-221/222 and miR-302c, were analyzed in human breast cancer samples by quantitative reverse transcription-PCR analysis. Correlations between the expression levels of these miRNAs and clinicopathological factors, including prognosis, were analyzed. miR-18a expression was much higher in ERα-negative than in ERα-positive tumors (P < 0.0001), with the expression levels of miR-18a not differing in ERα-positive breast cancer as a function of ERα protein level. Surprisingly, the expression levels of miR-193b and miR-221 were significantly lower in ERα-negative than in ERα-positive tumors (P = 0.0015 and P = 0.0045, respectively), and th...

Drug switch because of treatment-related adverse side effects in endocrine adjuvant breast cancer therapy: how often and how often does it work?

Breast Cancer Research and Treatment — Wed, 13 Jul 2011 06:00:40 +0100

Abstract Therapy-related adverse side effects are a main reason for non-persistence to adjuvant endocrine breast cancer therapy. This study reports frequency of drug-related adverse side effects that were so severe that a modification of the therapy was necessary. We evaluated how many patients discontinued adjuvant endocrine therapy because of these side effects (non-persistence). Last, we analyzed how often a drug switch was undertaken for this reason and how often this measure led to the patient successfully continuing their endocrine therapy. Data concerning all postmenopausal breast cancer patients (≤80 years), who initiated endocrine adjuvant therapy between 1998 and 2008 in a Swiss breast center (n = 400), were analyzed. Out of these 400 women, 37 (9...

Targeting Androgen Receptor in Estrogen Receptor-Negative Breast Cancer

Cancer Cell — Tue, 12 Jul 2011 00:00:00 +0100

Min Ni, Yiwen Chen, Elgene Lim, Hallie Wimberly, Shannon T. Bailey, Yuuki Imai, David L. Rimm, X. Shirley Liu, Myles Brown. Endocrine therapies for breast cancer that target the estrogen receptor (ER) are ineffective in the 25%–30% of cases that are ER negative (ER–). Androgen receptor (AR) is expressed in 60%–70% of b.... (Source: Cancer Cell)

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A comparison of international breast cancer guidelines – Do the national guidelines differ in treatment recommendations?

European Journal of Cancer — Mon, 11 Jul 2011 04:00:00 +0100

Abstract: Aim of the study: Clinical practice guidelines (CPG) are an appropriate method to optimise routine clinical care. Numerous CPGs for the diagnosis and treatment of breast cancer have been developed by national health institutions or medical societies. While a comparison of methodological criteria has been undertaken before, it is unknown whether these CPGs differ in their actual treatment recommendations.Methods: We included national breast cancer CPGs from the USA, Canada, Australia, the UK, and Germany that satisfy internationally recognised methodological criteria and are in widespread use in daily clinical care. Treatment recommendations for adjuvant invasive breast cancer including surgery, radiation, endocrine therapy, chemotherapy and anti-HER2-therapy were compared.Results...

High‐resolution genomic analysis of the 11q13 amplicon in breast cancers identifies synergy with 8p12 amplification, involving the mTOR targets S6K2 and 4EBP1

Genes, Chromosomes and Cancer — Sun, 10 Jul 2011 23:00:00 +0100

In conclusion, single nucleotide polymorphism arrays have enabled mapping of the 11q13 amplicon in breast tumors with high resolution. A proximal 11q13 core including S6K2 was identified as involved in the coamplification/coexpression with 8p12, suggesting synergy between the mTOR targets S6K2 and 4EBP1 in breast cancer development and progression. © 2011 Wiley‐Liss, Inc. (Source: Genes, Chromosomes and Cancer)

Management of Early Invasive Breast Cancer in Very Young Women (

Clinical Breast Cancer — Sun, 10 Jul 2011 23:00:00 +0100

CONCLUSION: The management of breast cancer in very young women requires a multidisciplinary team to find the optimal treatment and to solve their specific problems. PMID: 21752723 [PubMed - as supplied by publisher] (Source: Clinical Breast Cancer)

The Role of Interferon Regulatory Factor-1 (IRF1) in Overcoming Antiestrogen Resistance in the Treatment of Breast Cancer

Anesthesiology Research and Practice — Tue, 05 Jul 2011 14:55:02 +0100

Resistance to endocrine therapy is common among breast cancer patients with estrogen receptor alpha-positive (ER+) tumors and limits the success of this therapeutic strategy. While the mechanisms that regulate endocrine responsiveness and cell fate are not fully understood, interferon regulatory factor-1 (IRF1) is strongly implicated as a key regulatory node in the underlying signaling network. IRF1 is a tumor suppressor that mediates cell fate by facilitating apoptosis and can do so with or without functional p53. Expression of IRF1 is downregulated in endocrine-resistant breast cancer cells, protecting these cells from IRF1-induced inhibition of proliferation and/or induction of cell death. Nonetheless, when IRF1 expression is induced following IFNγ treatment, antiestrogen sensitiv...

Targeted therapy in breast cancer: what's new?

Swiss Medical Weekly — Wed, 29 Jun 2011 08:00:04 +0100

Authors: Fang L, Barekati Z, Zhang B, Liu Z, Zhong XY Breast cancer is the most commonly diagnosed malignancy and one of the major causes of death among women. Breast cancer is also one of the most investigated diseases but whose biological features are still not well understood, several effective treating strategies having been explored in dealing with different types of advanced breast cancer, such as endocrine therapy and molecular targeted therapy. Trastuzumab is the first approved targeted anti-cancer agent to show an attractive response rate and outcomes in treating HER-2 positive metastatic breast cancer patients. However, primary or acquired trastuzumab resistance usually occurs some time into the use of trastuzumab and leads to treatment resistance or tumour progression. The p...

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Reversal of endocrine resistance in breast cancer: interrelationships among 14-3-3zeta, FOXM1, and a gene signature associated with mitosis

Breast Cancer Research — Tue, 28 Jun 2011 23:00:00 +0100

Conclusions: This study reveals that 14-3-3zeta is a key predictive marker for risk of failure on endocrine therapy and serves a pivotal role impacting growth factor signaling, and promoting cell survival and resistance to endocrine therapies. Targeting 14-3-3zeta and its coregulated proteins, such as FOXM1, should prove valuable in restoring endocrine sensitivity and reducing risk of breast cancer recurrence. (Source: Breast Cancer Research)

Impact of Body Mass Index on the Efficacy of Endocrine Therapy in Premenopausal Patients With Breast Cancer: An Analysis of the Prospective ABCSG-12 Trial [Breast Cancer]

Journal of Clinical Oncology — Tue, 28 Jun 2011 23:00:00 +0100

Conclusion BMI significantly impacts on the efficacy of anastrozole plus goserelin in premenopausal patients with breast cancer, probably through influencing aromatase availability and/or ovarian suppression by goserelin. (Source: Journal of Clinical Oncology)

Exemestane versus anastrozole as front‐line endocrine therapy in postmenopausal patients with hormone receptor‐positive, advanced breast cancer

Cancer — Tue, 28 Jun 2011 23:00:00 +0100

CONCLUSIONS:In this phase 2 randomized trial, no significant differences in clinical activity were observed in favor of exemestane to justify a superiority phase 3 trial design in the first‐line setting. Cancer 2011;. © 2011 American Cancer Society. (Source: Cancer)

[Articles] Adjuvant endocrine therapy plus zoledronic acid in premenopausal women with early-stage breast cancer: 62-month follow-up from the ABCSG-12 randomised trial

The Lancet Oncology — Mon, 27 Jun 2011 16:48:59 +0100

SummaryBackgroundAnalysis of the Austrian Breast and Colorectal Cancer Study Group trial-12 (ABCSG-12) at 48 months' follow-up showed that addition of zoledronic acid to adjuvant endocrine therapy significantly improved disease-free survival. We have now assessed long-term clinical efficacy including disease-free survival and disease outcomes in patients receiving anastrozole or tamoxifen with or without zoledronic acid.MethodsABSCG-12 is a randomised, controlled, open-label, two-by-two factorial, multicentre trial in 1803 premenopausal women with endocrine-receptor-positive early-stage (stage I–II) breast cancer receiving goserelin (3·6 mg every 28 days), comparing the efficacy and safety of anastrozole (1 mg per day) or tamoxifen (20 mg per day) with or without zoledronic acid (4 mg e...

Strategies for subtypes--dealing with the diversity of breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011.

Ann Oncol — Sun, 26 Jun 2011 23:00:00 +0100

Authors: Goldhirsch A, Wood WC, Coates AS, Gelber RD, Thürlimann B, Senn HJ, The 12th St Gallen International Breast Cancer Conference (2011) Expert Panel adopted a new approach to the classification of patients for therapeutic purposes based on the recognition of intrinsic biological subtypes within the breast cancer spectrum. For practical purposes, these subtypes may be approximated using clinicopathological rather than gene expression array criteria. In general, systemic therapy recommendations follow the subtype classification. Thus, 'Luminal A' disease generally requires only endocrine therapy, which also forms part of the treatment of the 'Luminal B' subtype. Chemotherapy is considered indicated for most patients with 'Luminal B', 'Human Epidermal growth factor Receptor 2 (HER...

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Stability of HER2-positive status in breast carcinoma: a comparison between primary and paired metastatic tumors with regard to the possible impact of intervening trastuzumab treatment

Annals of Oncology — Wed, 22 Jun 2011 23:00:00 +0100

Conclusions: HER2-positive status remained unchanged in most paired metastases. Loss of HER2-positive status did not seem to be affected by trastuzumab treatment. Differences in testing and interpretation may account for the discordance in some cases. (Source: Annals of Oncology)

Use of aromatase inhibitors to treat endometriosis-related pain symptoms: a systematic review

Reproductive Biology and Endocrinology — Mon, 20 Jun 2011 23:00:00 +0100

In conclusion, AIs effectively reduce the severity of endometriosis-related pain symptoms. Since endometriosis is a chronic disease, future investigations should clarify whether the long-term administration of AIs is superior to currently available endocrine therapies in terms of improvement of pain, adverse effects and patient satisfaction. (Source: Reproductive Biology and Endocrinology)

Therapeutic resistance: Up or down?

Nature Reviews Cancer — Wed, 15 Jun 2011 23:00:00 +0100

Nature Reviews Cancer 11, 464 (2011). doi:10.1038/nrc3097 Author: Gemma K. Alderton Two papers identify new modulators of ERα expression, which has implications for responses of ERα+ breast cancer to endocrine therapy. (Source: Nature Reviews Cancer)

Cracking the Estrogen Receptor's Posttranslational Code in Breast Tumors.

ENDOCR REV — Tue, 14 Jun 2011 23:00:00 +0100

This article will provide an overview of the current and emerging knowledge on ER PTM, with a particular focus on their deregulation in breast cancer. We also discuss their clinical relevance and the functional relationship between PTM. A thorough understanding of the complete picture of these modifications in ER carcinogenesis might not only open new avenues for identifying new markers for prognosis or prediction of response to endocrine therapy but also could promote the development of novel therapeutic strategies. PMID: 21680538 [PubMed - as supplied by publisher] (Source: ENDOCR REV)

New therapies for ER-positive breast cancers

Society for Endocrinology — Mon, 06 Jun 2011 12:00:00 +0100

This study shows that factors which can re-establish cell cycle control have therapeutic potential for the treatment of breast cancers. Thangavel et al. (2011) Endocrine-Related Cancer 18 333–345. Read the full article at: DOI:10.1530/ERC-10-0262. (Source: Society for Endocrinology)

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Practice-Changing Cancer Trial Shows Additional Radiation Decreases Cancer Recurrence, Canada

Health News from Medical News Today — Mon, 06 Jun 2011 09:00:00 +0100

A Canadian-led clinical trial has found that additional radiation treatment improves disease-free survival in women with early breast cancer and reduces the risk of cancer recurrence, a finding that could change the standard treatment for this group of patients. The trial was led by the NCIC Clinical Trials Group, which is funded by the Canadian Cancer Society. The study enrolled more than 1,800 women who had been treated with breast-conserving surgery (lumpectomy) and adjuvant chemotherapy or endocrine therapy... (Source: Health News from Medical News Today)

Telomerase Expression and Telomere Length in Breast Cancer and their Associations with Adjuvant Treatment and Disease Outcome

Breast Cancer Research — Sun, 05 Jun 2011 23:00:00 +0100

Conclusions: Telomerase modified the effect of endocrine therapy on breast cancer survivals, suggesting that telomerase may serve as a marker to guide the selection of adjuvant treatment for breast cancer. (Source: Breast Cancer Research)

ERasing breast cancer resistance through the kinome

Nature Medicine — Sun, 05 Jun 2011 23:00:00 +0100

Authors: Amber B Johnson & Bert W O'Malley Estrogen receptor α (ERα)-positive breast cancers often find a way to circumvent endocrine therapies such as tamoxifen. A newly described ERα kinase, lemur tyrosine kinase-3 (LMTK3), may provide both a diagnostic advance and a new therapeutic target to fight these resistant, aggressive tumors. (Source: Nature Medicine)

Medical treatments of endocrine-sensitive Her-2 negative breast cancers: a review.

Bulletin du Cancer — Wed, 01 Jun 2011 23:00:00 +0100

Authors: Debled M, Dalenc F, Mauriac L, Brain E New molecular classification is one of the cornerstones of current and future progress in research and patient care for breast carcinoma. For the larger hormone-receptor positive and Her-2 negative subgroup, which concerns 75% of the patients, endocrine therapy and chemotherapy may be considered. Looking toward new-targeted therapies, this paper reviews the current use of these two treatment modalities in adjuvant, neoadjuvant and metastatic settings of this disease. PMID: 21636345 [PubMed - as supplied by publisher] (Source: Bulletin du Cancer)

The Impact of Breast Care Nurses on Patients’ Satisfaction, Understanding of the Disease, and Adherence to Adjuvant Endocrine Therapy

Breast Care : Last 20 articles — Wed, 01 Jun 2011 15:07:13 +0100

Breast Care 2011;6:4 (DOI:10.1159/000329006) (Source: Breast Care : Last 20 articles)

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Interaction between goserelin and tamoxifen in a prospective randomised clinical trial of adjuvant endocrine therapy in premenopausal breast cancer

Breast Cancer Research and Treatment — Mon, 30 May 2011 17:11:35 +0100

In conclusion, goserelin as well as tamoxifen reduces the risk of recurrence in endocrine responsive premenopausal breast cancer. Women with strongly ER-positive tumours may benefit more from goserelin treatment. The combination of goserelin and tamoxifen is not superior to either modality alone. With the limitations of a subset trial, these data have to be interpreted cautiously. Content Type Journal ArticlePages 1-9DOI 10.1007/s10549-011-1593-0Authors Asgerdur Sverrisdottir, Department of Oncology, Karolinska Institutet and University Hospital, Stockholm, SwedenHemming Johansson, Department of Oncology, Karolinska Institutet and University Hospital, Stockholm, SwedenUlla Johansson, Oncological Centre, Karolinska University Hospital, Stockholm, SwedenJonas Bergh, Department of O...

Duration of Chemotherapy for Metastatic Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Clinical Trials [Breast Cancer]

Journal of Clinical Oncology — Thu, 26 May 2011 23:00:00 +0100

Conclusion Longer first-line chemotherapy duration is associated with marginally longer OS and a substantially longer PFS. (Source: Journal of Clinical Oncology)

Interpreting Breast International Group (BIG) 1-98: a randomized, double-blind, phase III trial comparing letrozole and tamoxifen as adjuvant endocrine therapy for postmenopausal women with receptor-positive, early breast cancer

Breast Cancer Research — Wed, 25 May 2011 23:00:00 +0100

The Breast International Group (BIG) 1-98 study is a four-arm trial comparing 5 years of monotherapy with tamoxifen or with letrozole or with sequences of 2 years of one followed by 3 years of the other for postmenopausal women with endocrine-responsive early invasive breast cancer. From 1998 to 2003, BIG -98 enrolled 8,010 women. The enhanced design f the trial enabled two complementary analyses of efficacy and safety. Collection of tumor specimens further enabled treatment comparisons based on tumor biology. Reports of BIG 1-98 should be interpreted in relation to each individual patient as she weighs the costs and benefits of available treatments.Clinicaltrials.gov ID: NCT00004205. (Source: Breast Cancer Research)

Kinome screening for regulators of the estrogen receptor identifies LMTK3 as a new therapeutic target in breast cancer

Nature Medicine — Sat, 21 May 2011 23:00:00 +0100

Authors: Georgios Giamas, Aleksandra Filipović, Jimmy Jacob, Walter Messier, Hua Zhang, Dongyun Yang, Wu Zhang, Belul Assefa Shifa, Andrew Photiou, Cathy Tralau-Stewart, Leandro Castellano, Andrew R Green, R Charles Coombes, Ian O Ellis, Simak Ali, Heinz-Josef Lenz & Justin Stebbing Therapies targeting estrogen receptor α (ERα, encoded by ESR1) have transformed the treatment of breast cancer. However, large numbers of women relapse, highlighting the need for the discovery of new regulatory targets modulating ERα pathways. An siRNA screen identified kinases whose silencing alters the estrogen response including those previously implicated in regulating ERα activity (such as mitogen-activated protein kinase and AKT). Among the most potent regulators was lemur tyr...

Comparison of estrogen and progesterone receptor status of circulating tumor cells and the primary tumor in metastatic breast cancer patients.

Gynecologic Oncology — Fri, 20 May 2011 23:00:00 +0100

CONCLUSION: Most of the CTCs were ER/PR-negative despite the presence of an ER/PR- positive primary tumor. The predictive value of hormone receptor status expression profile of CTCs for palliative endocrine therapy has to be prospectively evaluated. STATEMENT: We recently demonstrated in more than 400 primary breast cancer patients that the expression profile between CTCs and the primary tumor with regard to ER/PR/HER2 positivity differs. The concordance rate between ER, PR and HER2 status of CTCs and the primary tumor was 29%, 25% and 53%, respectively (Fehm T et al., Breast Cancer Res Aug 10 2009, 11(4) pR59). Based on these results we studied blood samples of 193 metastatic breast cancer patients participating in the German DETECT study (1) to reevaluate the ER/PR expression by CTCs and...

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Hormone‐receptor expression and activity of trastuzumab with chemotherapy in HER2‐positive advanced breast cancer patients

Cancer — Wed, 18 May 2011 23:00:00 +0100

CONCLUSIONS:Our results suggest a predictive role of hormone receptor expression in HER2‐positive tumors. Further investigation in this patient subset is warranted to optimize the use of HER2‐targeting agents, chemotherapy, and endocrine therapy. Cancer 2011;. © 2011 American Cancer Society. (Source: Cancer)

Trastuzumab and pertuzumab produce changes in morphology and estrogen receptor signaling in ovarian cancer xenografts revealing new treatment strategies.

Clinical Cancer Research — Thu, 12 May 2011 23:00:00 +0100

ConclusionsThese data suggest that trastuzumab in combination with pertuzumab could be an effective approach in high HER2-expressing ovarian cancers and could also enhance sensitivity to endocrine therapy in ER{lower-case alpha}-positive ovarian cancer. PMID: 21571868 [PubMed - as supplied by publisher] (Source: Clinical Cancer Research)

Genomic Test Shows Promise as Predictor of Chemotherapy Response, Survival for Women With Invasive Breast Cancer

M. D. Anderson Cancer Center - News Releases — Wed, 11 May 2011 23:00:00 +0100

A new genomic test combining multiple signatures - a patient's estrogen receptor status, endocrine therapy response, chemotherapy resistance and sensitivity - shows promise as a predictor of chemotherapy response and survival benefit in women with invasive breast cancer, according to research led by The University of Texas MD Anderson Cancer Center. (Source: M. D. Anderson Cancer Center - News Releases)

Genomic Test Shows Promise As Predictor Of Chemotherapy Response, Survival For Women With Invasive Breast Cancer

Health News from Medical News Today — Wed, 11 May 2011 07:00:00 +0100

A new genomic test combining multiple signatures a patient's estrogen receptor status, endocrine therapy response, chemotherapy resistance and sensitivity shows promise as a predictor of chemotherapy response and survival benefit in women with invasive breast cancer, according to research led by The University of Texas MD Anderson Cancer Center. The findings, published in the May 11 issue of JAMA, also may determine those for whom standard therapy alone might not offer enough, and/or for whom an appropriate clinical trial in the adjuvant setting could provide additional benefit... (Source: Health News from Medical News Today)

Use Of Genetic Information May Help Predict Likelihood Of Survival Following Chemotherapy For Breast Cancer

Health News from Medical News Today — Tue, 10 May 2011 20:00:00 +0100

Development of a predictive test that included genomic signatures that indicated chemoresistance, chemosensitivity and endocrine sensitivity for women with newly diagnosed breast cancer identified patients with a high probability of survival following chemotherapy, according to a study in the May 11 issue of JAMA. Identification of patients with high likelihood of survival following a standard chemotherapy regimen (and then endocrine therapy, if estrogen receptor [ER]-positive) would reaffirm a treatment decision regarding the use of chemotherapy... (Source: Health News from Medical News Today)

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Genomic test shows promise as chemotherapy response, survival predictor for women with breast cancer

EurekAlert! - Medicine and Health — Tue, 10 May 2011 04:00:00 +0100

(University of Texas M. D. Anderson Cancer Center) A new genomic test combining multiple signatures -- a patient's estrogen receptor status, endocrine therapy response, chemotherapy resistance and sensitivity -- shows promise as a predictor of chemotherapy response and survival benefit in women with invasive breast cancer, according to research led by the University of Texas MD Anderson Cancer Center. (Source: EurekAlert! - Medicine and Health)

A Genomic Predictor of Response and Survival Following Taxane-Anthracycline Chemotherapy for Invasive Breast Cancer [Original Contribution]

JAMA — Mon, 09 May 2011 23:00:00 +0100

Conclusion A genomic predictor combining ER status, predicted chemoresistance, predicted chemosensitivity, and predicted endocrine sensitivity identified patients with high probability of survival following taxane and anthracycline chemotherapy. (Source: JAMA)

Toremifene is an effective and safe alternative to tamoxifen in adjuvant endocrine therapy for breast cancer: results of four randomized trials

Breast Cancer Research and Treatment — Fri, 06 May 2011 16:24:28 +0100

Abstract Compared to tamoxifen, the efficacy and side effects of toremifene in adjuvant endocrine therapy for breast cancer were not very clear. This meta-analysis was conducted to give a more precise estimation of the efficacy and severe side effects of toremifene given in the adjuvant setting in comparison to tamoxifen. The electronic database PubMed was searched for randomized trials comparing toremifene with tamoxifen as adjuvant therapies. Four randomized trials published in three articles were eligible, including 1,890 pooled cases treated with toremifene and 1,857 cases treated with tamoxifen. Compared to patients in tamoxifen group, patients in toremifene group did not have a significantly different overall survival rate (risk ratio (RR): 1.07, 95% confidence inter...

Dealing with a troublesome body: A qualitative interview study of men's experiences living with prostate cancer treated with endocrine therapy.

European Journal of Oncology Nursing — Thu, 05 May 2011 23:00:00 +0100

CONCLUSION: This study showed that hormone treatment has a significant influence, both directly and indirectly, on the bodies of prostate cancer patients. The experiences of men with prostate cancer may lead to feelings of loss of identity on an existential level. PMID: 21550304 [PubMed - as supplied by publisher] (Source: European Journal of Oncology Nursing)

Aging and osteoporosis in breast and prostate cancer.

Clinical Prostate Cancer — Tue, 03 May 2011 23:00:00 +0100

Authors: Vanderwalde A, Hurria A As people with cancer survive longer, and as the US population ages, skeletal effects of cancer treatment are becoming more pronounced. This is particularly true for breast and prostate cancer survivors because of the high average age of patients with these malignancies, the propensity of older adults in general toward the development of osteoporosis, and the wide use of therapeutic agents in these cancers that negatively impact bone health. Various therapies used in the treatment and prevention of cancer may cause decreases in bone mineral density and an increased risk of debilitating fracture, even in the absence of bone metastases. Aging is both a baseline risk factor in the development of osteoporosis and bony fracture, as well as a predictor of poo...

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Fulvestrant Revisited: Efficacy and Safety of the 500-mg Dose.

Clinical Genitourinary Cancer — Tue, 03 May 2011 23:00:00 +0100

Authors: Howell A, Sapunar F Postmenopausal women with hormone receptor-positive advanced breast cancer are candidates for endocrine therapy. As the disease will eventually progress in most patients, it is important to investigate agents with novel modes of action to reduce the likelihood of treatment cross-resistance. Fulvestrant is an estrogen receptor antagonist with no known agonist effects that has been shown to be as effective as anastrozole following failure on tamoxifen, at the approved dose of 250 mg/mo. However, pharmacokinetic modelling and evidence of clinical efficacy in early trials, together with the favorable tolerability profile of fulvestrant 250 mg, led to suggestions that increasing the fulvestrant dose would lead to an improved benefit-risk profile. This review des...

Aging and osteoporosis in breast and prostate cancer

CA: A Cancer Journal for Clinicians — Sat, 30 Apr 2011 23:00:00 +0100

AbstractAs people with cancer survive longer, and as the US population ages, skeletal effects of cancer treatment are becoming more pronounced. This is particularly true for breast and prostate cancer survivors because of the high average age of patients with these malignancies, the propensity of older adults in general toward the development of osteoporosis, and the wide use of therapeutic agents in these cancers that negatively impact bone health. Various therapies used in the treatment and prevention of cancer may cause decreases in bone mineral density and an increased risk of debilitating fracture, even in the absence of bone metastases. Aging is both a baseline risk factor in the development of osteoporosis and bony fracture, as well as a predictor of poor outcome after fracture. A v...

Correction: Cytokine Receptor CXCR4 Mediates Estrogen-Independent Tumorigenesis, Metastasis, and Resistance to Endocrine Therapy in Human Breast Cancer

Cancer Research — Thu, 28 Apr 2011 23:00:00 +0100

(Source: Cancer Research)