breast cancer research

San Antonio Breast Cancer Symposium (SABCS)

By Bhanu Vakkalanka MD, MRCP, FRCR, Mid-Illinois Hematology and Oncology Associates.
an Antonio is the venue for a large international breast cancer conference held every year in the month of December. This meeting is very well attended and often is the forum where groundbreaking research is presented from all over the world. There were a lot of interesting presentations from 2012 of which I will be discussing a few of the important ones below. Tamoxifen is widely used as hormonal therapy in the management of estrogen receptor positive breast cancers. This drug is mainly used in the pre-menopausal patients, typically for five years. Long-term data from an international study called ATLAS showed that taking the drug for 10 years rather than five years results in an improved survival. These data, however, can only be applicable to the younger pre-menopausal patients, as the efficacy of this strategy in post-menopausal patients is unclear at this time. In another trial called AZURE, all patients with stage 2 and 3 breast cancer were treated with standard treatments alone or standard ther-

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apy and Zoledronic acida bone-strengthening agentlooking for improved outcomes. No overall difference was seen in disease-free survival but a subgroup analysis showed some benefit in the postmenopausal patients. Further analysis revealed that patients with normal Vitamin D levels had a lower risk of bone metastasis and a trend towards reduced risk of recurrence. There is increasing evidence that maintaining adequate vitamin D levels may have a beneficial effect in cancer patients. Most patients with breast cancer undergoing breast preservation surgery receive radiation therapy to reduce the risk of local recurrence. The standard method of delivering radiation is by focusing high-energy photons to the involved breast, which is called external beam radiation therapy (EBRT). Some researchers also studied targeted intraoperative radiotherapy (TARGIT), using a mobile electron generator. A study from the U.K. reported a higher local recurrence, but reduced overall mortality with TARGIT, compared to women receiving EBRT. This is however a small study, with several limitations and hence EBRT continues to be the standard of treatment. Bevacizumab was a widely used drug in metastatic breast cancer until the FDA revoked its approval in November 2011 due to conflicting data regarding its effectiveness. This decision was highly controversial, as the European Medicines Agency has maintained its approval of this drug for metastatic breast cancer patients. Several trials have been undertaken for years, looking to expand the role of this drug into the adjuvant therapy of breast cancer. Some of those trials were presented in SABCS which failed to reveal any added benefit with this drug in early breast cancer. Based on these data, the profile of this drug in breast cancer is likely to diminish further, although it continues to be used for the treatment of other cancers such as lung, colon, etc. Early trial reports suggest that a new drug called PD991 has shown significant improvement in progression-free survival in patients with advanced breast cancer, when used in combination with letrozole, a well-established drug in breast cancer. The median progression free survival was 26.1 months for the combination compared to 7.5 months with letrozole alone. Although very promising, further advanced clinical trials need to be completed before the drug can be used in clinical practice. Overall, although there were no ground breaking presentations in this years SABCS, there were several significant advances in research which will, undoubtedly, move forward the care of breast cancer patients in the U.S.A. and all over the world. For more information, you may contact Mid-Illinois Hematology & Oncology Associates, Ltd. 309-452-9701. They are located inside the Community Cancer Center at 407 E. Vernon Avenue in Normal. MidIllinois Hematology & Oncology Associates, Ltd. is currently participating in national research studies for breast cancer including a Vitamin D prevention study for premenopausal women, a study of Herceptin with radiation therapy for very early stage breast cancer, and a study designed to personalize treatment for women with breast cancer that has spread to the lymph nodes.

211 Landmark Drive - Suite E1 Normal, IL

(Across from Shermans)

309.268.9304
Page 28 Healthy Cells Magazine Bloomington April 2013
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