Breast Cancer

Patients with HER2+ breast cancer who develop resistance to trastuzumab may soon have an alternative therapy, according to recent findings published in Clinical Cancer Research.

The combination of everolimus and trastuzumab shows promise against metastatic breast cancer in pretreated, HER2-positive patients with trastuzumab resistance, according to results of a phase 1/2 study. This targeted, nonchemotherapy regimen provided partial responses in 7 of 47 patients and persistent stable disease (lasting 6 months or longer) in 9 of 47 patients. The regimen produced a clinical benefit rate of 34%, and median progression-free survival was 4.1 month.

 

After 2 days of hearings, the Oncologic Drugs Advisory Committee (ODAC) confirmed the US Food and Drug Administration’s (FDA) earlier decision to remove bevacizumab’s (Avastin, Genentech) indication in combination with paclitaxel chemotherapy for previously untreated (first-line) HER2-negative metastatic breast cancer.

 

SALT LAKE CITY—Bisphosphonates may have a role as an adjuvant breast cancer treatment, cisplatin-based neoadjuvant chemotherapy should be considered for treating bladder cancer, and dose-dense chemotherapy may add benefit for patients with pediatric Ewing sarcoma, according to 3 presentations at the “Controversies in Care” session at the annual meeting of the Hematology/Oncology Pharmacy Association.

Bisphosphonates in Breast Cancer

The US Food and Drug Administration (FDA) has approved Inform Dual ISH (Ventana Medical Systems), a genetic test that allows for measurement of the number of copies of the HER2 gene in tumor tissue. This method of identification of women with breast cancer who are HER2-positive pinpoints who is, and who is not, a candidate for Herceptin (trastuzumab).

 

Blocking miR-21 overexpression was found to retrieve trastuzumab sensitivity in trastuzumab-resistant breast cancer cells, in a study of cell lines derived from HER2-postive breast carcinomas. This theory was derived from identification of overexpression of miR-21 in HER-positive, trastuzumab-resistant cells. The researchers also found that miR-21 upregulation in trastuzumab-resistant cells led to PTEN reduction.

 

The evidence backing the use of myeloid growth factors in patients at high risk for febrile neutropenia is solid, according to Jeffrey Crawford, MD, of Duke Cancer Institute, Durham, North Carolina.

Myeloid growth factors are the primary means of preventing chemotherapy-induced neutropenia. This often leads to febrile neutropenia, which can be fatal in 10% of patients, according to a database of more than 40,000 individuals. Concerns recently have been raised, however, that their use is associated with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML).

Trastuzumab (Herceptin) has greatly improved survival odds for women with HER2-positive breast cancer, but treatment resistance remains a problem for at least 50% of patients. A new study by a team of researchers with University of Texas MD Anderson Cancer Center indicates that the novel agent saracatinib might offer a solution. Saracatinib inhibits SRC, a proto-oncogene.
 
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