Notes from LBBC Teleconference "Breaking News from 31st Annual San Antonio Breast Cancer Symposium"

Speaker: Dr. Kathy Miller

Adjuvant Hormone Therapy

-Increased use of Aromatase Inhibitors -- better survival than Tamoxifen 

-Also discussed: OncoDX Score, Big 198 Study

Studies now looking at how women metabolize Tamox and Aromatase inhibitors and seeing if it is possible to choose the therapy based on the enzymes inherited (how well a person metabolizes these). Can hormone therapy be individualized to people?

-Bone health -- aromatase has increased bone loss risk, studies show bisphosphanates are important to administer immediately with aromatase therapy

Adjuvant Chemotherapy (CURE article here)

FinnXx Study -- incorporating Xeloda (capecitabine) -- HER2-, lymph node involvement 

NSABP30 Trial & BCROG(?) Trial (gave 6 cycles instead of 4). These trials looked at the TAC (Taxotere, Adriamycin, Cytoxin) regimen  and compared dosage, sequence. 

Three arms of the trials:

1. 4 Adria then 4 tax on 3 week cycle each (sequential arm) -- lower risk of recurrence of all 
   
2. 4 A + 4 T
   
3. 4TAC
   

Summary:

The second trial adminstered 6 doses versus 4. There was no significant difference found between fewer doses, but the sequential arm had the lowest recurrence of all and fewer side effects (probably due to lower dosages of the high toxicity drugs). Conclusion is that the TAC schedule does not offer improved outcome and TAC should be "retired".  Recommendations coming out are to make treatment interval every 2 weeks or taxanes weekly and get rid of the TAC regimen.

HER2+ news

Lapatnib -- benefit for metastatic HER2+ 

TDM1  (Trastuzumab)

Triple Negative Breast Cancer and Chemotherapy

approval of drug ixabepilone shows benefit for Triple Negative  (in combination with Xeloda)

Again, no studies being reported at San Antonio broke out pre- vs post-menopausal women! Argh!