Online tool helps narrow down treatment options for breast cancer

BY MELISSA WEBER | NOVEMBER 19, 2009

My Breast Cancer Coach is pretty straightforward: Answer a handful of questions about your type of breast cancer and in return you get a personalized report of treatment options to talk over with your doctor.

The online tool has been available for over a year, but it recently re-launched with some new features, including information for stage 0 patients, a podcast series, and a "Get Answers" page that offers Q&As with experts.

Created by the nonprofits Breastcancer.org and Breast Cancer Network of Strength as well as the life science company Genomic Health (it markets the Oncotype DX breast cancer test), My Breast Cancer Coach also offers a glossary and a list of questions to ask your doctor.

Want to know the top cancer advances for 2009?

BY MELISSA WEBER | NOVEMBER 9, 2009

Each year, the American Society of Clinical Oncology releases a report that pinpoints the top advances in cancer treatment, prevention and screening. This year, ASCO identified 15 key advances in four areas. (The advances were not ranked.)

Here's a breakdown of the findings, provided by ASCO:

1. Advances in Personalized Medicine and Targeted Therapies

Multiple trials this year demonstrated that oncology is no longer "one size fits all" medicine. Rather, increased understanding of the biology of cancer is enabling researchers to develop highly targeted drugs and personalized treatment regimens for patients. Advances in this category include:

• The targeted drug trastuzumab (Herceptin), which has been successful against breast tumors that overexpress the HER2 protein, was found to improve survival for HER2+ gastric cancer. [We'll cover this topic in detail in the Winter issue of CURE, which drops in December.]

• Researchers identified the first effective immunotherapy for neuroblastoma – chimeric anti-GD2 antibody ch.14.18.

• For the first time in 30 years, a randomized trial identified a regimen – initial chemotherapy combined with the EGFR-targeted drug cetuximab (Erbitux) – that increases survival for people with metastatic head and neck cancer.

• Researchers identified a specific subset of patients with non-small cell lung cancer (NSCLC) who benefit from first-line treatment with the targeted drug gefitinib (Iressa). [Watch for our lung cancer feature in the Spring 2010 issue of CURE, which publishes in March.]

• The FDA approved new indications for targeted drugs to treat glioblastoma and advanced kidney cancer, both highly challenging forms of cancer. Bevacizumab (Avastin) was approved as a single agent for treatment of glioblastoma and when combined with interferon, for treatment of advanced kidney cancer. Additionally, everolimus (Afinitor) was approved for kidney cancer in patients whose disease has progressed despite treatment with other targeted drugs. [Read our kidney cancer coverage here.]

2. New Standards of Care

Results from several long-awaited clinical trials this year affirmed the superiority of certain treatment regimens for biliary, lung, and prostate cancers. These include:

• The first-ever standard of care for advanced biliary cancer (cancers of the gallbladder and bile ducts) – results from the largest clinical trial to date for this disease stage showed that combination gemcitabine (Gemzar) and cisplatin treatment increases survival and slows cancer progression, compared with gemcitabine treatment alone.

• Data from a late-stage trial reporting that maintenance therapy with pemetrexed (Alimta) extends survival for patients with nonsquamous forms of advanced NSCLC – a finding that establishes a new standard and gives patients a long-term, easily-administered treatment option with low toxicity. [Watch for our lung cancer feature in the Spring 2010 issue of CURE, which drops in March.]

• Practice-changing findings showing that radiation following prostatectomy improves survival and reduces risk of metastasis for men with early-stage prostate cancer.

3. Cancer Prevention and Screening

This year, findings from large trials shed new light on widely used cancer detection, monitoring and prevention tools. Major research advances in this category include:

• Interim results from two large trials showing that routine PSA testing has a minimal effect on reducing prostate cancer mortality – findings that add new insight to a long-time debate. [Read our coverage here.]

• A large trial showing that treating relapsed ovarian cancer based on rising levels of a protein in the blood called CA125 does not improve outcomes, compared with monitoring for physical symptoms of ovarian cancer relapse. These findings will help spare women from the anxiety and costs of frequent CA125 testing, as well as the toxicity of earlier treatment. [Read our coverage here.]

• Research suggesting that more women may benefit from HPV vaccination than previously thought, based on findings showing that Gardasil reduces the risk of HPV infection, cervical cancer and other HPV-related disease in women aged 25 to 45.

4. Large Trials Settle Key Debates in Colon, Breast Cancer Treatment

The results of two closely watched studies settled major debates in the treatment of colon and breast cancers. These include:

• In the first trial to examine bevacizumab in the adjuvant setting, researchers demonstrated that adjuvant bevacizumab treatment does not prevent colon cancer recurrence in patients who have undergone surgery for their disease. [Read our coverage here.]

• Standard three-drug chemotherapy is more effective and less toxic than single-drug treatment with capecitabine (Xeloda) in women age 65 and older undergoing adjuvant treatment for early-stage breast cancer. Researchers had thought that single-drug treatment may be more tolerable for older women, but this was not found to be the case.

The full report--plus reports from previous years--is available at www.cancer.net.

Want a free ticket to see 'Kaleidoscope' taping?

BY MELISSA WEBER | NOVEMBER 5, 2009

Cancer advocacy groups, sanofi-aventis US, and show producers have teamed up to offer cancer survivors a free ticket to the taping of Kaleidoscope, a television special to raise awareness for cancers that affect women.

The taping is Monday, November 16, at 7 p.m. at the Verizon Center in Washington, D.C., so if you're a cancer survivor who wants to attend, go to www.ticketmaster.com and enter "survivor" as the special offer code to get your free ticket (you'll have to cover a $2 per ticket handling charge).

Although the song-writing contest that Olivia Newton-John announced at ASCO's annual meeting this summer didn't pan out, the actress and singer will still perform at the event, as will American Idol's David Archuleta, Olympic figure skaters Scott Hamilton and Dorothy Hamill, and others.

The special will air on FOX at 4 p.m. Eastern on Thanksgiving Day. Get details at www.womenandcancer.com.

Leukemia drug gets nod from FDA

BY MELISSA WEBER | OCTOBER 26, 2009

Only one week after approving a new drug for kidney cancer, the Food and Drug Administration approved another new cancer drug--Arzerra (ofatumumab) for patients with chronic lymphocytic leukemia.

The approval was based on a study in which about half of patients whose cancers didn't respond to other therapies responded to Arzerra. Similar to Rituxan (rituximab), Arzerra is a monoclonal antibody that targets the CD20 receptor on cancer cells. (Read more about Rituxan in "Trying Something New" from the Spring 2009 issue.)

Because Arzerra was approved under the FDA's accelerated approval process, which allows early approval of treatments that meet an unmet need for a specific disease, research is still ongoing to look at how well the agent delays progression of the cancer.

The FDA said the most serious side effects of Arzerra are increased risk of infections, including a brain infection called progressive multifocal leukoencephalopathy that is generally fatal. The agency said patients who are at high risk for hepatitis B should be screened before taking Arzerra. Common side effects include a decrease in blood counts, pneumonia, fever, and fatigue, among others.

For more, visit CURE's leukemia page.

New drug approved to treat kidney cancer

BY MELISSA WEBER | OCTOBER 20, 2009

It's been a productive few years in kidney cancer for the Food and Drug Administration. Since 2005, the FDA has approved six drugs to treat kidney cancer--three in the past eight months alone, the latest being Votrient (pazopanib).

Word came late Monday that the agency approved the oral drug for advanced renal cell carcinoma, only two weeks after a panel that advises the FDA recommended the agency give the drug the green light. (Check out CURE's coverage of the ODAC recommendation.)

The other targeted drugs approved for kidney cancer include Sutent (sunitinib), Nexavar (sorafenib), Torisel (temsirolimus), Afinitor (everolimus), which was approved in March, and Avastin (bevacizumab), which received the FDA nod in August.

At a conference I attended earlier this year, kidney cancer expert Robert Figlin, MD, made a prediction: Afinitor and Avastin would be approved for kidney cancer in 2009. Check, and check. And within two years, he said, pazopanib would get the thumbs up. I guess the FDA didn't want to wait. By the way, Figlin made another prediction about a drug called axitinib; we'll keep you posted.

Read CURE's extensive coverage of the latest in treating kidney cancer in "Reining in Renal Cancer" from the Summer 2009 issue.

PBS’s Arthur and Lance Armstrong team up to help you talk to kids about cancer

BY MELISSA WEBER | OCTOBER 16, 2009

When the lunch lady, Mrs. MacGrady, gets cancer on next week's episode of Arthur, the kids unite to help her--with a little help from Lance, of course.

The Lance Armstrong Foundation partnered with the PBS children's series to create the special episode, which airs every weekday next week (check your local listings here).

Plus, free resources on LAF's website help families and teachers talk with children about cancer. Parents can download the Family Activity Booklet, and kindergarten through second-grade teachers can download lesson plans that use the Arthur episode to help children express the emotions the show portrays of knowing someone diagnosed with cancer, and what they can do to reach out and help that person.

Check out CURE's article on what kids need and want to know when a parent is diagnosed in "Straight Talk."

Breast cancer survivor tells Jon Stewart to just say no to positive thinking

BY MELISSA WEBER | OCTOBER 15, 2009

On last night's episode of The Daily Show, author Barbara Ehrenreich (her latest book is called Bright-sided: How the Relentless Promotion of Positive Thinking Has Undermined America) talked about her breast cancer diagnosis eight years ago.

Instead of finding the support she needed, she was told things like "be positive" and "embrace your disease" and "you'll come out a better person." That's not what she wanted or needed to hear, she told Stewart, adding that those types of statements can do more harm than good.

In the upcoming Winter issue, we're running an article about how some survivors have found a silver lining to their cancer experience. Of course, not all survivors feel this way. Check out "Being Positive?" from a previous issue for more on this topic, and tell us what you think.

Breast cancer documentary premieres this Sunday

BY MELISSA WEBER | OCTOBER 8, 2009

Take a break from football this weekend and check out a new documentary designed to promote early cancer detection and treatment among African Americans.

TV One partnered with Susan G. Komen for the Cure to produce Breast Cancer Examined: An African American Perspective, which airs this Sunday at 7 p.m. Eastern. (If you can't catch it Sunday night, the special will re-air at 4 a.m. on Monday; October 16 at 1 p.m.; and October 18 at 4 p.m.)

Viewers go where the patients go, through the stages of treatment and survival. These personal stories allow the filmmakers to educate viewers about the different types of breast cancer, the various kinds of treatment, and survivorship. A number of celebrities appear in the film, including actor Richard Roundtree, syndicated radio personality Ebony Steele, and actresses Diahann Carroll and Gabrielle Union.

Visit www.circleofpromise.org to get details on Circle of Promise, Komen's African American breast cancer initiative, and check out the story CURE ran about how to overcome the challenges minorities face when it comes to early cancer detection and access to care.

A new resource for breast cancer patients

BY MELISSA WEBER | SEPTEMBER 30, 2009

Just in time for breast cancer awareness month comes a new DVD you might want to check out that offers insight and information from top breast cancer experts (Dennis Slamon and Patricia Ganz, along with numerous others), advice from wellness experts, and personal stories from survivors--some of whom are familiar: Christina Applegate, Sheryl Crow, and Olivia Newton-John to name a few.

Here's a quick look at some of the topics covered in Breast Cancer: The Path of Wellness & Healing:

> Risk, Detection & Diagnosis
> Personal Testimonials
> Building Your Personal & Medical Team
> Talking to Your Kids
> Surgery, Breast Reconstruction, Chemotherapy, Radiation Therapy, Hormonal Therapy, and Side Effects
> Boosting Physical Resilience With Food, Supplements, Exercise & Meditation
> Cutting-Edge Advances in Research

The two-DVD set is available on Amazon starting Thursday, and you can find details about the project at www.breastcancerdvd.org.

Hormonal therapy for prostate cancer may cause heart problems

BY MELISSA WEBER | SEPTEMBER 22, 2009

We've talked a lot about the possibility of heart damage for breast cancer patients taking Herceptin or patients receiving an anthracycline, but new research shows there's also a chance that prostate cancer patients taking hormonal treatment may develop heart problems, although some types of therapy appear to be less risky than others.

The study, presented in Berlin at a joint meeting of the European Cancer Organisation and the European Society for Medical Oncology, looked at more than 30,000 Swedish men who received hormonal therapy for about three years to treat advanced prostate cancer.

"If we have observed a causative effect, then for all hormone therapies put together, we estimate that compared with what's normal in the general population, about 10 extra ischaemic heart disease events a year will appear for every 1,000 prostate cancer patients treated with such drugs," the study's leader, Mieke Van Hemelrijck, a cancer epidemiologist at King's College in London, said in a statement. "However, not all types of therapy were associated with the risk of heart problems to the same degree. We found that drugs which block testosterone from binding to the prostate cells were associated with the least heart risk, while those that reduce the production of testosterone were associated with a higher risk. This may have implications for treatment choice."

Researchers believe testosterone has some protective effect on the heart, so interfering with that could be harmful--a thinking supported by the data. The increased heart failure risk for anti-androgens (for example, Casodex and Nilandron) was 5 percent, compared with 34 percent for gonadotropin-releasing hormone agonists (for example, Zoladex and Lupron); the increased risk for ischaemic heart disease (reduced blood supply to the heart) was 13 percent in the anti-androgen group, compared with 30 percent in the gonadotropin-releasing hormone agonist therapy group. For men who had their testicles removed, the heart risk was close to that seen with gonadotropin-releasing hormone agonist therapy.

Although the risk is small and may ultimately be outweighed by the benefits of hormonal therapy to treat prostate cancer, experts say men, particularly those at risk for heart disease, should talk with their doctor. Heart function may need to be monitored during treatment, and some patients may require referral to a cardiologist before starting treatment.