This is the latest post in a bi-monthly series where we take a look at several of the most interesting cancer research stories that have come out over the previous two months. These are a few of the recent stories that seem to have the greatest potential impact, at least from my perspective, and that I know I’ll want to follow as they develop further.
In early May, the American Society of Clinical Oncology (ASCO) held its annual meeting in Chicago. In the area of breast cancer treatment, this meeting included reports on several interesting studies about ways that patients can benefit from new uses of existing drugs.
Also at ASCO, there was much discussion of immune system therapies, currently a very high-profile area of research. Although not yet a big area in breast cancer treatment, numerous clinical trials in immune system therapies are ongoing in a variety of cancers.
And in other news, the findings of a major study on breast cancer risk and environmental toxins were published. The study identifies high risk chemicals and paves the way for further research in this important area.
Breast Cancer Treatment
Tamoxifen Alternative: Younger women with early stage hormone-sensitive breast cancer are often prescribed the anti-estrogen therapy, tamoxifen. Tamoxifen is generally taken for at least 5 years, and recent research shows there is benefit in extending the treatment out to 10 years. Tamoxifen, however, can have side effects that make its long-term use difficult for some women.
Research presented at ASCO shows there is a valid alternative to anti-estrogen therapy with tamoxifen. In ongoing studies testing this approach, exemestane (Aromasin) was given to premenopausal women along with treatment to suppress ovarian function. Based on the studies’ findings over a 5-year period, the alternative approach is considered equally effective to therapy with tamoxifen.
Future results from these studies will tell us more about comparative survival benefits and long-term side effects. Aromatase inhibitors such as Aromasin have side effects too that need to be considered as well. However, this alternative is an option that may make sense for some patients.
Preserving fertility: An important issue for many younger women diagnosed with cancer is whether they will still be able to have children after treatment. There were some interesting findings from a recent phase III clinical trial that apply to women with early stage hormone-negative breast cancer who are interested in preserving fertility after treatment. This study showed that temporarily suppressing the function of the ovaries with a medication called goserelin during chemotherapy treatment increases the chances that a woman will be able to become pregnant and deliver a healthy baby after chemotherapy is finished.
Care for metastatic breast cancer patients: Patients with breast cancer that has spread to the bone are often given medications such as zoledronic acid (Zometa) to reduce complications such as broken bones and spinal compression. But long-term treatment with these medications carries the risk of certain serious side effects. Findings from a phase III clinical trial showed that less frequent treatment with Zometa is equally effective to the standard treatment schedule and reduces the risk of these serious side effects.
For more about these findings from ASCO on breast cancer treatment, here are several good resources: (1) “ASCO: Early-stage breast cancer study results,” a short video from CureToday; (2) “Breast Cancer Treatments That Shut Down the Ovaries: What you need to know” by Dr. Susan Love; and (3) “Breast Cancer Updates from ASCO,” by Dr. Julie Gralow.
Immune System Therapies
A big area in cancer research now is finding ways to help the body’s own immune system to fight cancer. This approach is being studied in many types of cancer but results so far have been most promising in treating advanced melanoma. It’s interesting that when immune system boosting therapies do work for patients (and they only work for some), they seem to have fairly long-lasting benefits. More research is needed to understand which patients will benefit and why.
One of the most promising experimental drugs for advanced melanoma is called MK-3475, and results of a large, phase I study of this drug were presented as ASCO. This particular immune system therapy works by blocking the function of a protein called PD-1 (programmed death-1) that prevents white blood cells from effectively fighting the cancer. In this study of over 400 people with melanoma that had spread to other parts of the body, 34% had tumors that responded to the treatment. After about a year, 88% of the patients whose tumors responded to the treatment had not gotten worse. These results are considered to be pretty impressive for advanced melanoma and this is an area of research that is being followed closely.
If you’re interested in reading more about immune system therapies, one recent article to take a look at is “New System for Treating Cancer Seen as Hopeful” in the New York Times. I’ve also included a link below under Other Reading for the full patient research round-up from ASCO, which includes several reports on immune system-related therapies.
Breast Cancer Risk
Only about 5-10% of breast cancer cases are linked to inherited genetic mutations. Gaining an improved understanding of the impact of environmental toxins is likely to be an important part of learning how to eventually reduce the numbers of women and men impacted by breast cancer.
A new study reported in the journal Environmental Health Perspectives identifies 17 categories of chemicals that have been shown to cause breast cancer in lab animals and are also likely to cause breast cancer in humans. These are all chemicals that we are broadly exposed to in our food, consumer products, in the air and in drinking water.
The report lists specific actions that women can take to reduce their exposure to these likely carcinogens. And it also provides a road map for future research to establish the specific effect of each of these types of chemicals on women’s bodies.
This research was conducted by the Silent Spring Institute. You can find more information about the study on their website.
For a more complete summary of new research findings presented at ASCO, Research Round Up: News for Patients from the 2014 ASCO Annual Meeting is a very readable overview, presented from the patient’s perspective.
Some cancer patients are experiencing remarkable benefits from a variety of experimental targeted and immune system therapies being studied in clinical trials. In this article in the New York Times, Susan Gubar writes about her experience in a clinical trial for a targeted treatment for ovarian cancer.
That’s it for this time. If there was another recent cancer research story or article that caught your attention or if you have thoughts on any of what I’ve included, I’d love to hear from you!