Metastatic Breast Cancer

Source: www.ncbi.nlm.nih.gov --- 14 days ago
Related Articles Metastatic Breast Cancer: the treatment challenge. Clin Breast Cancer. 2008 Jun;8(3):224-33 Authors: Jones SE As therapeutic options have multiplied, chemotherapy for Metastatic Breast Cancer (MBC) has become increasingly complex. Furthermore, advances in the treatment of early-stage Breast Cancer, in particular the development of taxane-based regimens, have led to increased use of adjuvant chemotherapy. As a result, the decisions regarding the treatment of patients presenting with MBC have become more difficult, because many patients are likely to have received a variety of adjuvant chemotherapy regimens. The primary goal of treatment for MBC is palliation of disease--usually with prolongation of survival--with minimal toxicity. However, there is currently no "gold standard" in this setting, and the literature supports many choices for first- and second-line treatment. Other issues as yet unsettled in these patients are (1) whether to combine >or= 2 drugs or to use each drug alone until disease progression; (2) how to use novel targeted biologic agents; and (3) how to treat patients with HER2-overexpressing tumors after adjuvant treatment with trastuzumab. The role of taxanes, antimetabolites, and targeted agents in patients with MBC will be discussed in this review, particularly in the context of previous adjuvant therapy. The controversy surrounding the use of doublet or sequential therapy will also be discussed. Alt ...

Source: www.ncbi.nlm.nih.gov --- 6 days ago
Related Articles Therapeutic options in the management of Metastatic Breast Cancer. Oncology (Williston Park). 2008 May;22(6):614-23; discussion 623, 627-9 Authors: Higgins MJ, Wolff AC Breast Cancer is the second leading cause of Cancer-related death in women in the United States, and for nearly all with Metastatic disease at presentation or relapse it will be incurable. The goals of therapy are to optimize quality of life and, if possible, prolong time to progression of disease and death. For a select group of patients an aggressive surgical approach may be considered. Initial palliation with endocrine therapy should be the primary consideration for patients with Metastatic hormone receptor-positive tumors. Cytotoxic chemotherapy is appropriate for those with hormone-refractory disease, rapidly progressive visceral disease, or early relapse after adjuvant therapy. If a tumor overexpresses HER2, targeted treatment with trastuzumab (Herceptin) or lapatinib (Tykerb) is possible. Consequently, accurate determination of the status of these predictive markers in tissue (possibly from a recurrence site) is key. Other novel agents are adding to the wide choices of standard chemotherapies already available. This review offers an approach to the selection of individualized and rational therapies for patients with Metastatic Breast Cancer. PMID: 18561551 [PubMed - indexed for MEDLINE] ...

Source: www.moreover.com --- 19 days ago
© 2008 AlphaMed Press This Article CME: Take the course for this article: All Versions of this Article: 13/7/739 most recent eLetters: Submit a response to this article Google Scholar Breast Cancer Central Nervous System Metastases in ...

Source: www.ncbi.nlm.nih.gov --- 9 days ago
Intrathecal trastuzumab (Herceptin) and methotrexate for meningeal carcinomatosis in HER2-overexpressing Metastatic Breast Cancer: a case report. Anticancer Drugs. 2008 Sep;19(8):832-6 Authors: Stemmler HJ, Mengele K, Schmitt M, Harbeck N, Laessig D, Herrmann KA, Schaffer P, Heinemann V Leptomeningeal carcinomatosis represents a rare manifestation of Metastatic Breast Cancer (MBC). We herewith report on a patient suffering from HER2 overexpressing MBC who received intrathecal methotrexate and trastuzumab for meningeal carcinomatosis. A 48-year-old woman was diagnosed with Breast Cancer in December 2002. Following surgery, six cycles of adjuvant FE100C plus irradiation and, subsequently for 1 year, trastuzumab were given. As a result of disseminated Metastatic spread in October 2005, the patient received whole-brain radiotherapy for symptomatic central nervous system involvement, and was put on several trastuzumab-based combination regimens (capecitabine, vinorelbine, paclitaxel). In June 2006, the patient developed clinical signs of terminal cone involvement with overflow incontinence and paraparesis of the legs. Immediate radiation led to partial relief from clinical symptoms. Subsequently, the patient was put on the tyrosine kinase inhibitor lapatinib and capecitabine (August to October 2007), but on November 6th the patient suffered again from overflow incontinence and weakness of the legs. Failing to respond to lapatinib, the patie ...

Source: www.ncbi.nlm.nih.gov --- 14 days ago
Related Articles Beyond cytotoxic chemotherapy for the first-line treatment of HER2-negative, hormone-insensitive Metastatic Breast Cancer: current status and future opportunities. Clin Breast Cancer. 2008 Jun;8(3):215-23 Authors: Conlin AK, Seidman AD As reflected in its varied clinical behavior, appearances under the light microscope, and differential patterns of gene expression, Metastatic Breast Cancer (MBC) is a heterogeneous disease. Systemic treatment decisions are guided by specific tumor characteristics and individual patient factors. For patients with hormone receptor (HR)-negative MBC and for those whose HR-positive disease has become refractory to hormonal therapies, cytotoxic chemotherapy has been the mainstay of systemic treatment. For hormone-insensitive, HER2-positive MBCs, the addition of trastuzumab to chemotherapy has resulted in improved outcomes. Hormone-insensitive MBC lacking HER2 overexpression includes the subset of patients with estrogen receptor/ progesterone receptor/HER2-negative (so-called triple-negative) disease, which represents a significant minority of all Breast cancers. Therapeutic options for such patients are limited by the lack of specific targeted approaches, and this heterogeneous group will be considered collectively as well as separately in this overview of existing and emerging treatment strategies. Conventional cytotoxic chemotherapy, alone or in combination, has been the standard first-line ...

Source: www.ncbi.nlm.nih.gov --- 14 days ago
Related Articles A phase II study of weekly vinorelbine and trastuzumab in patients with HER2-positive Metastatic Breast Cancer. Clin Breast Cancer. 2008 Jun;8(3):264-8 Authors: Bayo-Calero JL, Mayordomo JI, Sánchez-Rovira P, Pérez-Carrión R, Illaramendi JJ, García-Bueno JM, González-Flores E, Crespo C, Ramos-Vázquez M, García-Palomo A, Ruiz-Borrego M, de la Haba J, Gómez-Bernal A, Yubero-Esteban A BACKGROUND: Trastuzumab combined with cytotoxic agents presents encouraging results in Metastatic Breast Cancer (MBC), but cardiac toxicity limits some combinations. The synergism shown with trastuzumab and the favorable tolerability profile of vinorelbine provided the rationale for investigating this combination. PATIENTS AND METHODS: Patients with HER2-positive MBC who had received <2 lines of chemotherapy for Metastatic disease were included. Vinorelbine (25 mg/m2 on day 2, then weekly on day 1) and trastuzumab (4 mg/kg on day 1, then 2 mg/kg weekly) were administered for a maximum of 6 cycles (1 cycle=3 weeks). RESULTS: A total of 52 patients were enrolled. The median age was 50 years (range, 26-79 years). Ninety percent of the patients had received adjuvant chemotherapy, 42% received a first line of chemotherapy for MBC, and 69% had disease at visceral sites. The overall response rate was 58% (95% CI, 43%-71%). The median time to progression and overall survival were 7 months (95% CI, 5-9 months) and 26 months (95% CI, 20-32 months), res ...

Source: www.moreover.com --- 35 days ago
Women with Metastatic Breast Cancer want more treatment options and greater awareness of their disease. A recent medical conference helped give them both. ...

Source: www.moreover.com --- 37 days ago
-- The China State Food and Drug Administration has approved albumin-bound paclitaxel ABI-007 (Abraxane) for the treatment of Breast Cancer after failure of standard chemotherapy for Metastatic disease or relapse within 6 months of adjuvant ...

Source: www.ncbi.nlm.nih.gov --- 42 days ago
Related Articles Cost-effectiveness of HER2 testing and trastuzumab therapy for Metastatic Breast Cancer. Acta Oncol. 2008 Feb 1;:1-11 Authors: Lidgren M, Wilking N, Jonsson B, Rehnberg C Background. Trastuzumab is a monoclonal antibody that together with chemotherapy significantly improves time to progression and overall survival for Metastatic Breast Cancer patients with tumours overexpressing HER2. The aim of this study was to analyse the cost-effectiveness of HER2 testing and trastuzumab in combination with chemotherapy compared with chemotherapy alone from a societal perspective in a Swedish setting. Material and methods. We used a Markov state transition model to simulate HER2 testing and subsequent treatment in a hypothetical cohort of 65 year old Metastatic Breast Cancer patients. Outcomes included life-time costs, quality adjusted life years (QALY), and cost per QALY gained. Five different testing and treatment strategies were evaluated. Results. We estimated the cost per QALY gained to be about 485 000 SEK for the strategy of IHC testing for all patients, with FISH confirmation of 2+ and 3+, and trastuzumab and chemotherapy treatment for FISH positive patients. For the strategy of FISH testing for all patients, with trastuzumab and chemotherapy for FISH positive patients, we estimated the cost per QALY gained to about 561 000 SEK. The remaining testing and treatment strategies were dominated. Results were sensitive to changes ...

Source: www.ncbi.nlm.nih.gov --- 20 days ago
Related Articles Effect of Lapatinib on the Outgrowth of Metastatic Breast Cancer Cells to the Brain. J Natl Cancer Inst. 2008 Jul 29; Authors: Gril B, Palmieri D, Bronder JL, Herring JM, Vega-Valle E, Feigenbaum L, Liewehr DJ, Steinberg SM, Merino MJ, Rubin SD, Steeg PS Background The brain is increasingly being recognized as a sanctuary site for Metastatic tumor cells in women with HER2-overexpressing Breast Cancer who receive trastuzumab therapy. There are no approved or widely accepted treatments for brain metastases other than steroids, cranial radiotherapy, and surgical resection. We examined the efficacy of lapatinib, an inhibitor of the epidermal growth factor receptor (EGFR) and HER2 kinases, for preventing the outgrowth of Breast Cancer cells in the brain in a mouse xenograft model of brain metastasis. Methods EGFR-overexpressing MDA-MB-231-BR (231-BR) brain-seeking Breast Cancer cells were transfected with an expression vector that contained or lacked the HER2 cDNA and used to examine the effect of lapatinib on the activation (ie, phosphorylation) of cell signaling proteins by immunoblotting, on cell growth by the tetrazolium salt 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay, and on cell migration using a Boyden chamber assay. The outgrowth of large (ie, >50 mum(2)) and micrometastases was counted in brain sections from nude mice that had been injected into the left cardiac ventricle with 231-BR cells ...

Source: www.ncbi.nlm.nih.gov --- 35 days ago
Related Articles Phase II Trial of Gemcitabine/Carboplatin (plus Trastuzumab in HER2-Positive Disease) in Patients with Metastatic Breast Cancer. Clin Breast Cancer. 2008 Apr 1;8(2):178-186 Authors: Loesch D, Asmar L, McIntyre K, Doane L, Monticelli M, Paul D, Vukelja S, Orlando M, Vaughn LG, Zhan F, Boehm KA, O'Shaughnessy JA Background: Gemcitabine and carboplatin have significant preclinical synergy, and both provide synergistic antitumor activity in Metastatic Breast Cancer (MBC) when used in combination with trastuzumab. The gemcitabine/ cisplatin combination is highly active in MBC with response rates (RRs) of approximately 50% in anthracycline- and taxane-pretreated patients and up to 80% in untreated subjects. This phase II trial studied the efficacy and safety of gemcitabine/carboplatin with or without trastuzumab in patients with MBC. Patients and Methods: Patients were stratified into 3 groups: group 1, HER2-positive; group 2, HER2-negative and taxane- naive/remote (no taxanes within past 2 years); and group 3, HER2-negative and previous taxane therapy. Included were women aged >/= 18 years, Eastern Cooperative Oncology Group performance status of 0-2, with Response Evaluation Criteria in Solid Tumors-defined measurable MBC; HER2-negative or HER2 (3+) by immunohistochemistry or fluorescence in situ hybridization positive. All cycles were repeated every 14 days. On day 1, gemcitabine 1500 mg/m2 over 30 minutes was administer ...

Source: www.ncbi.nlm.nih.gov --- 22 days ago
Related Articles Serum HER-2/neu and relative resistance to trastuzumab-based therapy in patients with Metastatic Breast Cancer. Cancer. 2008 Jul 25; Authors: Ali SM, Carney WP, Esteva FJ, Fornier M, Harris L, Köstler WJ, Lotz JP, Luftner D, Pichon MF, Lipton A, BACKGROUND.: Previous reports based on small patient numbers suggested that changes in serum HER-2/neu levels may predict response or lack of response to trastuzumab-based therapies in Metastatic Breast Cancer (MBC). The objectives of this study were to pool data from 307 patients with MBC from 7 medical institutions to validate that the serum HER-2/neu profile predicts patient resistance to trastuzumab and to establish a clinically relevant cutoff. METHODS.: This was an international, multicenter, retrospective analysis of individual pooled data from 307 patients with MBC who were treated with first-line trastuzumab-based therapy. Serum was collected at baseline and 30 to 120 days after the initiation of trastuzumab therapy. A serum HER-2/neu decrease >/=20% (receiver operating curve analysis) was defined as a significant HER-2/neu change. RESULTS.: Of the 307 patients with MBC, 191 patients (62%) had a significant decline (>20%) in serum HER-2/neu and 116 patients (38%) did not. The objective response rate was 57% for patients who achieved this decline in serum HER-2/neu (>20%) compared with 28% for patients who did not. Patients who achieved this decline in serum HER-2/neu ...

Source: www.ncbi.nlm.nih.gov --- 25 days ago
Related Articles Vinorelbine-based salvage therapy in HER2-positive Metastatic Breast Cancer patients progressing during trastuzumab-containing regimens: a retrospective study. BMC Cancer. 2008 Jul 24;8(1):209 Authors: Montemurro F, Redana S, Nole F, Donadio M, Jacomuzzi ME, Valabrega G, Viale G, Sapino A, Aglietta M ABSTRACT: BACKGROUND: The vinka-alkaloyd vinorelbine is a potentially valuable treatment in patients with HER2-positive, trastuzumab-resistant advanced Breast Cancer. We sought to document the clinical activity of vinorelbine-based salvage treatments in this clinical setting. METHODS: We analyzed a cohort of 424 consecutive women receiving trastuzumab-based therapy for HER2-positive advanced Breast Cancer. Of these, 299 were identified as progressing during the initial trastuzumab-based treatment, and 77 received vinorelbine-based therapy as first salvage treatment. Central review of pathological specimens revealed that 70 patients had HER2-amplification detected by FISH. For these patients we determined overall response rate (ORR = complete-CR + partial-PR) and clinical benefit (CB = CR+PR+Stable disease lasting at least 6 months), time to progression (TTP) and overall survival (OS) from the initiation of vinorelbine-based salvage therapy. RESULTS: In 60 patients who were evaluable for tumor response, ORR and CB rates were 28% (95% C.I. 18%-41%) and 50% (95% C.I. 38%-62%), respectively. Median follow-up from the initiatio ...

Source: www.ncbi.nlm.nih.gov --- 32 days ago
Related Articles Efficacy and safety of trastuzumab plus capecitabine in heavily pretreated patients with HER2-positive Metastatic Breast Cancer. Cancer Chemother Pharmacol. 2008 Jun;62(1):159-64 Authors: Osako T, Ito Y, Takahashi S, Tokudome N, Iwase T, Hatake K PURPOSE: We retrospectively evaluated the efficacy and safety of combination therapy of trastuzumab plus capecitabine in heavily pretreated patients with HER2-positive Metastatic Breast Cancer (MBC). METHODS: Patients with HER2-positive MBC who had been administered the combination therapy between July 2003 and July 2006 at the Cancer Institute Hospital, Tokyo, were retrospectively reviewed. Capecitabine (828 mg/m(2)) was given twice daily for 3 weeks followed by a 1-week rest period; this was repeated every 4 weeks. Trastuzumab was given at 4 mg/kg as an initial loading dose intravenously, followed by 2 mg/kg weekly. We investigated objective response rate (ORR), clinical benefit rate (CBR), and time-to-treatment failure (TTF) according to the Response Evaluation Criteria in Solid Tumors guidelines. Adverse events were graded according to the National Cancer Institute, Common Toxicity Criteria, version 3.0. RESULTS: A total of 49 patients were assessed and median follow-up time of patients was 16.2 months (1.4-43.5 months). ORR was 16% (95% confidence interval: 7-30%) and CBR was 47% (95% confidence interval: 32-62%). Median TTF was 5.4 months. Common adverse effects were ha ...

Source: www.moreover.com --- 37 days ago
Therapeutics Daily Jul 14 2008 3:52PM GMT ...

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TMC Net Jul 23 2008 5:12PM GMT ...

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Pharmaceutical Business Review Aug 16 2008 4:43AM GMT ...

Source: www.medicalnewstoday.com --- 2 days ago
ImClone Systems Incorporated (NASDAQ: IMCL), a global leader in the development and commercialization of novel antibodies to treat Cancer, today announced that the first patient has been treated in a global Phase 3 clinical trial of IMC-1121B, its anti-vascular endothelial growth factor receptor-2 (VEGFR-2) IgG1 monoclonal antibody, in women with Metastatic Breast Cancer. ...

Source: content.karger.com --- 29 days ago
Tumor Biol 2008;29:181-187 (DOI:10.1159/000146863) ...

Source: www.breastrisk.com --- 32 days ago
This is in line with most retrospective analyses and recent randomized info. Of the remaining 82 patients, 59 retained trastuzumab for one or more additional lines of chemotherapy after PD, according to our institution policy. We plus compared survival of these patients with that of those who halted trastuzumab at first PD. Methods: We identified [...] ...