Breast cancer awareness

Archive for October, 2009

BERLIN – The potent oral multiple kinase inhibitor sorafenib (NexavarR) combined with the chemotherapy drug capecitabine (XelodaR) significantly improves progression-free survival (PFS) over capecitabine alone in patients with locally advanced or metastatic HER-2 negative breast cancer, according to phase 2b results released at the joint 15th European Cancer Organization (ECCO) and 34^th European Society for Medical Oncology (ESMO) Multidisciplinary Congress.

In fact, the data showed a 74% higher median PFS in the sorafenib/capecitabine group than in the group receiving chemotherapy alone.

The study is the first, large-scale randomized investigation to document significant clinical activity for sorafenib in breast cancer when combined with chemotherapy, ESMO President Jose Baselga, MD, chairman of the oncology division at Vall d’Hebron Institute of Oncology in Barcelona, said.

Professor Baselga and colleagues elsewhere randomized 229 women to treatment with capecitabine (1000 mg/m² taken twice daily for 14 of every 21 days) and a placebo OR capecitabine and sorafenib (400 mg taken twice daily continuously).

The study followed a phase 1 trial showing limited toxicity with sorafenib 400 mg BID and capecitabine 850 mg/m² BID.

In the phase 2b trial, all women had locally advanced or metastatic HER-2 negative breast cancer and had received no more than one prior chemotherapy for advanced/metastatic breast cancer.

The primary endpoint was PFS.

Results demonstrated that the median PFS was significantly longer in the sorafenib/capecitabine combination group than the placebo/capecitabine alone group (6.4 months versus 4.1 months for the two groups, respectively).
Further analysis revealed that first-line patients who received the sorafenib-capecitabine combination had a median PFS of 7.6 months. Patients who got the combination as second-line therapy had a median PFS of 5.7 months.

The combination treatment was well tolerated and produced no new or unexpected adverse side effects.

Overall survival data are not yet available.

“This is a very positive study, and the magnitude of the benefit is such that this agent will be an important addition to our therapeutic armoury [sic] in breast cancer,” Professor Baselga said.

He also noted that “the fact that this treatment can be taken orally may represent a unique and convenient “treatment option in breast cancer patients.

The study was co-sponsored by Onyx Pharmaceuticals Inc. and Bayer Health Care.

Written by Jill Stein
Jill Stein is a Paris-based freelance medical writer.

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

Social environment can play an important role in the biology of disease, including breast cancer, and lead to significant differences in health outcome, according to results of a study published in Cancer Prevention Research, a journal of the American Association for Cancer Research.

“This study uses an elegant preclinical model and shows that social isolation alters expression of genes important in mammary gland tumor growth,” said the journal’s Deputy Editor Caryn Lerman, Ph.D. “It further elucidates the molecular mechanisms linking environmental stress with breast cancer development and progression.”

These findings suggest novel targets for chemoprevention, and future studies should evaluate whether these molecular processes can be reversed by chemopreventive agents, according to Lerman, who is the Mary W. Calkins professor of psychiatry and scientific director of the Abramson Cancer Center at the University of Pennsylvania, Philadelphia.

Previous results from clinical studies have indicated that social support can improve the health outcome of patients with breast cancer. Epidemiological studies have suggested that social isolation increases the mortality risk from several chronic diseases.

Suzanne D. Conzen, M.D., associate professor in the department of medicine and the Ben May department for cancer research at the University of Chicago, along with colleagues from the Institute of Mind and Biology at the University of Chicago, evaluated whether an unfavorable social environment could influence tumor growth in mice that are genetically predisposed to mammary gland cancer.

They found that female mice that were chronically stressed because of social isolation (from the time they were first separated from their mothers) developed significantly larger mammary gland tumors compared to those mice that were group-housed.

Additionally, the isolated mice developed a heightened corticosterone stress hormone response.

“Despite the genetic similarity of the mice assigned to grouped versus isolated housing, living in the stressful environment was associated with greater tumor size, suggesting that the social environment may in fact alter the biology of cancer growth…then, of course, the question becomes how,” she said.
The researchers studied gene expression in the mouse mammary tissues and found that alterations in the expression levels of metabolic pathway genes, which are expected to favor increased tumor growth, had occurred in the isolated mice even before tumor size differences were measurable. These gene expression patterns suggest potential molecular biomarkers and/or targets for preventive intervention in breast cancer.

Further research is needed to focus on which specific cell types the changes in gene expression are taking place, according to Conzen. This knowledge could potentially lead to interventions that block similar pathways favoring the growth of human breast cancer.

“Given the increased knowledge of the human genome we can begin to objectively identify and dissect the specific alterations that take place in cancer-prone tissues of individuals in at-risk environments and that will help us to better understand and implement cancer prevention strategies,” she concluded.

The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, AACR is the world’s oldest and largest professional organization dedicated to advancing cancer research. The membership includes more than 28,000 basic, translational and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and nearly 90 other countries. The AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants. The AACR Annual Meeting attracts more than 17,000 participants who share the latest discoveries and developments in the field. Special conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment and patient care. The AACR publishes six major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; Cancer Epidemiology, Biomarkers and Cancer Prevention Research. The AACR also publishes CR, a magazine for cancer survivors and their families, patient advocates, physicians and scientists. CR provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship and advocacy.

Source: American Association for Cancer Research

On the eve of Breast Cancer Awareness Month, Cancer Research UK today sends out a warning that if thousands of women continue to ignore invitations to breast screening they could be putting their lives at risk.

The NHS breast screening figures have shown that around three in 10 women still do not attend screening*.

In 2008, out of 2.2 million women who were sent an invitation for screening, 1.7 million attended – around 73 per cent.

Now experts are predicting that if all women attended screening when invited, then around 600 extra lives could be saved each year.

In January the number of women in England newly invited for screening fell below 70 per cent for the first time.

Former airline stewardess Barbara Gibbs, from Berkshire, believes a routine mammogram saved her life. Twelve years ago she was diagnosed with breast cancer after she was called back for a second mammogram after she had gone for breast screening.

“After surgery I was given six weeks of radiotherapy and then put on tamoxifen for five years,” says Barbara who is now 68. “I was lucky because my cancer was caught early even though I had no lump and no symptoms.

“I wouldn’t be alive today if I hadn’t gone for that mammogram. I feel very positive that I am a survivor and I just can’t emphasise how strongly I feel that women must take up their invitation to breast screening. It certainly saved my life because the cancer was caught early and treated promptly.”

Doreen Walker, from Potters Bar, who now volunteers in one of Cancer Research UK’s charity shops, was also diagnosed with breast cancer following a routine mammogram 16 years ago, a year after retiring from the NHS.

“I feel very lucky to have been picked up by screening. I made sure I went for a mammogram every three years and honestly believe I wouldn’t be here today if it wasn’t for breast screening. I would certainly recommend that all women go for their appointments – it is vital for every woman and could save their life,” says Doreen who is now 78.

With more than 45,500 women diagnosed with breast cancer in 2006 it is now the most common cancer in the UK.

In England the NHS breast screening programme diagnoses around 10,000 cases of breast cancer each year and saves around 1,400 lives every year.

Dr Lesley Walker, Cancer Research UK’s director of cancer information, said: “Screening saves lives, so it’s extremely worrying to see that the percentage of women going for screening is dropping. Mammograms pick up the very early signs of breast cancer when it’s much easier to treat. Even though the screening programme saves around 1,400 lives each year we predict that if there was 100 per cent attendance, hundreds more lives could be saved.

“Although there has been some criticism of the breast cancer screening programme in the past it is still the best weapon we have in the early detection of a disease that affects more than 45,500 women every year. Our research has found that screening has reduced breast cancer death rates by up to a quarter in women within the screening age range, while international research found that for every 500 women screened, one life will be saved.

“But it’s vital that we’re not complacent. Monitoring and improving the screening programme, including the information available to women, is important to ensure women are fully aware of the benefits and any possible risks of screening.”

Professor Stephen Duffy, Cancer Research UK’s professor of cancer screening at Queen Mary, University of London, said: “Most women who go for screening are reassured to be told that they don’t have breast cancer. But, it’s still important for all women who are invited to attend. For the minority who do get breast cancer, catching it early through screening means women are more likely to be successfully treated and less likely to need a mastectomy.”

Professor Julietta Patnick, Director of the NHS Breast Cancer Screening Programme, commented: “The NHS Breast Cancer Screening Programme welcomes the support of Cancer Research UK in encouraging women to accept their screening invitations. The Programme is working hard to understand the factors that affect women’s uptake of invitations in order to provide the best possible service, and to provide women with the right information for them to make their decision.”

Notes

To find out how to get involved in Breast Cancer Awareness Month and help raise funds to save lives click here.

*from “Breast Screening Programme, England 2007-08″ NHS Information Centre, Jan 2009 – uptake figures for 50-70 year olds.

Source
Cancer Research UK

Using mice as a model to study human breast cancer, researchers have demonstrated that a negative social environment (in this case, isolation) causes increased tumor growth. The work shows – for the first time – that social isolation is associated with altered gene expression in mouse mammary glands, and that these changes are accompanied by larger tumors.

“This interdisciplinary research illustrates that the social environment, and a social animal’s response to that environment, can indeed alter the level of gene expression in a wide variety of tissues, not only the brain,” said Suzanne D. Conzen, MD, associate professor of medicine at the University of Chicago and senior author of the study, published on September 30, 2009, in. “This is a novel finding and may begin to explain how the environment affects human susceptibility to other chronic diseases such as central obesity, type 2 diabetes, hypertension, etc.”

The research began six years ago when cancer specialist Conzen joined forces with biobehavioral psychologist Martha McClintock, PhD, professor of psychology and founder of the Institute for Mind and Biology at the University of Chicago, who has long been interested in the result of social isolation in aging, to study behavior and cancer in a mouse model.

The University of Chicago scientists took mice that were genetically predisposed to develop mammary gland (breast) cancer and raised them in two environments: in groups of mice and isolated. After the same amount of time, the isolated mice grew larger mammary gland tumors. They were also found to have developed a disrupted stress hormone response.

“I doubted there would be a difference in the growth of the tumors in such a strong model of genetically inherited cancer simply based on chronic stress in their environments, so I was surprised to see a clear, measurable difference both in mammary gland tumor growth and interestingly in accompanying behavior and stress hormone levels,” Conzen said.

The researchers then turned their attention to how the chronic social environment affected the biology of cancer growth. In other words, they sought to discover the precise molecular consequences of the stressful environment.

To do this, they studied gene expression in the mouse mammary tissue over time. Conzen and her colleagues found altered expression levels of metabolic pathway genes (which are expected to favor increased tumor growth) in the isolated mice. This was the case even before tumor size differences were measurable.

These altered gene expression patterns suggest potential molecular biomarkers and/or targets for preventive intervention in human breast cancer.

“Given the increased knowledge of the human genome, we can begin to identify and analyze the specific alterations that take place in caner-prone tissues of individuals living in at-risk environments,” Conzen said. “That will help us to better understand and implement cancer prevention strategies.”

These findings do suggest novel targets for chemoprevention, according to Caryn Lerman, PhD, Scientific Director of the Abramson Cancer Center at the University of Pennsylvania, Philadelphia and Deputy Editor of Cancer Prevention Research. “Future studies should evaluate whether these molecular processes can be reversed by chemopreventive agents.”

The findings also support previous epidemiologic studies suggesting that social isolation increases the mortality of chronic diseases, as well as clinical studies revealing that social support improves the outcomes of cancer patients.

The research was funded by the National Institutes of Health Centers for Population Health and Human Disparities; the University of Chicago Cancer Center’s Women’s Auxiliary Board; and the University of Chicago Cancer Center.

The paper is titled “A Model of Gene-Environment Interaction Reveals Altered Mammary Gland Gene Expression and Increased Tumor Growth following Social Isolation.” is published by the American Association for Cancer Research.

The following scientists will address the new research:

Suzanne D. Conzen, MD, associate professor of medicine at the University of Chicago and senior author of the study published in

Caryn Lerman, PhD, professor of psychiatry and scientific director of the Abramson Cancer Center at the University of Pennsylvania, Philadelphia and Deputy Editor of

Scott Lippman, MD, professor and chair, Thoracic/Head and Neck Medical Oncology, University of Texas M.D. Anderson Cancer Center

Thea Tlsty, PhD, professor of pathology, director of the Center for Translational Research in the Molecular Genetics of Caner, and director of the Program of Cell Cycling and Signaling, University of California San Francisco

Source:
Greg Borzo

University of Chicago Medical Center