Glossary
January 16, 2009 – Jennifer M. Gangloff
Breaking News from ASCO
June 09, 2006 – Staff Reports
House Call
June 09, 2006 – Jay Thomas, MD, PhD
Breast Cancer & MDS
January 09, 2009 – Elizabeth Whittington
Bookshelf
June 09, 2006 – Kathy LaTour
Web Exclusive: Follow-Up Care for Skin Cancer
June 09, 2006 – The National Cancer Institute
Weighing Prevention Versus Cost
June 09, 2006 – Melissa Knopper
Diagnosing Skin Cancer
June 09, 2006 – Susan R. Peck, PhD
Sharing a Lifetime
June 09, 2006
Sunburn Reasons & Remedies
June 09, 2006 – Monica Zangwill, MD
Inherited Syndromes Link Cancers
June 09, 2006 – Elizabeth Whittington
Future Risk for Survivors
June 09, 2006 – Rabiya S. Tuma, PhD
Nature's Spoils
June 09, 2006 – Elizabeth Whittington
The Discovery of Taxol
June 09, 2006 – Frank Stephenson
Melanoma: The Other Skin Cancer
June 09, 2006 – Elizabeth Whittington
Picture Not Perfect
June 09, 2006 – Elizabeth Whittington
Science of Suncreen
June 09, 2006 – Elizabeth Whittington
Planning for Death
June 09, 2006 – Elizabeth Whittington
Does Heaven Exist?
June 09, 2006 – Jo Cavallo
To Be or Not To Be: Is That the Right Question?
June 09, 2006 – Harvey Max Chochinov, MD PhD
Is It Time to Change the Design of Clinical Trials?
June 09, 2006 – Alice McCarthy
Drink Up
June 09, 2006 – Elizabeth Whittington
A Life Well-Lived
June 09, 2006 – Deborah Lang Hampton
Web Exclusive: Caregivers Often Neglect Their Mental Health
June 09, 2006 – The American Cancer Society
Letters from Our Readers
June 09, 2006
Message from the Editor-at-Large
June 09, 2006 – Kathy LaTour
Choosing a Counselor
June 09, 2006 – Elizabeth Whittington
Tips for Preventing Infection
June 09, 2006 – Elizabeth Whittington
Cancer as a Legacy
June 09, 2006 – Kathy LaTour
Fighting Cancer Together
June 09, 2006 – Elizabeth Whittington
Running on Empty
June 09, 2006 – Melissa Knopper
The Blame Game
June 09, 2006 – Kathy LaTour
People & Places
June 09, 2006 – Elizabeth Whittington
A Beautiful Day: The Story of a Son's Loss
June 09, 2006 – Kevin Cropp
Surf & Turf
June 09, 2006 – Jennifer M. Gangloff
Nonmelanoma Skin Cancer: Saving Your Skin
June 09, 2006 – Monica Zangwill, MD
Confronting Death
June 09, 2006 – Jo Cavallo
Glossary
January 16, 2009 – Jennifer M. Gangloff
Breaking News from ASCO
June 09, 2006 – Staff Reports
House Call
June 09, 2006 – Jay Thomas, MD, PhD
Currently Viewing
Breast Cancer & MDS
January 09, 2009 – Elizabeth Whittington
Web Exclusive: Follow-Up Care for Skin Cancer
June 09, 2006 – The National Cancer Institute
Weighing Prevention Versus Cost
June 09, 2006 – Melissa Knopper
Diagnosing Skin Cancer
June 09, 2006 – Susan R. Peck, PhD
Sharing a Lifetime
June 09, 2006
Sunburn Reasons & Remedies
June 09, 2006 – Monica Zangwill, MD
Inherited Syndromes Link Cancers
June 09, 2006 – Elizabeth Whittington
Future Risk for Survivors
June 09, 2006 – Rabiya S. Tuma, PhD
Nature's Spoils
June 09, 2006 – Elizabeth Whittington
The Discovery of Taxol
June 09, 2006 – Frank Stephenson
Melanoma: The Other Skin Cancer
June 09, 2006 – Elizabeth Whittington
Picture Not Perfect
June 09, 2006 – Elizabeth Whittington
Science of Suncreen
June 09, 2006 – Elizabeth Whittington
Planning for Death
June 09, 2006 – Elizabeth Whittington
Does Heaven Exist?
June 09, 2006 – Jo Cavallo
To Be or Not To Be: Is That the Right Question?
June 09, 2006 – Harvey Max Chochinov, MD PhD
Is It Time to Change the Design of Clinical Trials?
June 09, 2006 – Alice McCarthy
Drink Up
June 09, 2006 – Elizabeth Whittington
A Life Well-Lived
June 09, 2006 – Deborah Lang Hampton
Web Exclusive: Caregivers Often Neglect Their Mental Health
June 09, 2006 – The American Cancer Society
Letters from Our Readers
June 09, 2006
Message from the Editor-at-Large
June 09, 2006 – Kathy LaTour
Choosing a Counselor
June 09, 2006 – Elizabeth Whittington
Tips for Preventing Infection
June 09, 2006 – Elizabeth Whittington
Cancer as a Legacy
June 09, 2006 – Kathy LaTour
Fighting Cancer Together
June 09, 2006 – Elizabeth Whittington
Running on Empty
June 09, 2006 – Melissa Knopper
The Blame Game
June 09, 2006 – Kathy LaTour
People & Places
June 09, 2006 – Elizabeth Whittington
A Beautiful Day: The Story of a Son's Loss
June 09, 2006 – Kevin Cropp
Surf & Turf
June 09, 2006 – Jennifer M. Gangloff
Nonmelanoma Skin Cancer: Saving Your Skin
June 09, 2006 – Monica Zangwill, MD
Confronting Death
June 09, 2006 – Jo Cavallo

Breast Cancer & MDS

Breast cancer prevention trial and Dacogen approved for myelodysplastic syndromes. 

BY Elizabeth Whittington
PUBLISHED January 09, 2009

One of the largest global breast cancer prevention trials ever conducted found that a drug that treats and prevents osteoporosis called Evista (raloxifene) is as effective in preventing invasive breast cancer as standard tamoxifen, but questions surround the impact of side effects associated with each drug.  

The STAR trial (Study of Tamoxifen and Raloxifene), which enrolled nearly 20,000 postmenopausal women with a high risk of breast cancer, compared the effects of daily Evista with tamoxifen for five years and found both drugs reduce the risk of invasive breast cancer by half. Despite this finding, it remains unclear which drug is superior. Tamoxifen was associated with fewer cases of noninvasive (in situ) breast cancer, a risk factor for invasive cancer. But tamoxifen increased the risk of cataracts and led to more uterine cancers and blood clots than Evista. Authors of an editorial published in the Journal of the American Medical Association wrote: “Although media coverage of the early release of data from the STAR trial suggest a clear ‘winner’ in raloxifene, the data from clinical endpoints and patient-reported symptoms suggest a less clear conclusion. Assuming U.S. regulatory approval of raloxifene to prevent breast cancer, physicians should discuss these two similar options carefully with their eligible and interested patients.”

Like tamoxifen, Evista is a selective estrogen receptor modulator (SERM), which helps prevent estrogen from binding to cancer cells and inhibits cancer cell growth. As a SERM, Evista also stops the thinning of bone tissue and increases the amount of good tissue, hence lowering the risk of bone fracture. Approved for treating and preventing osteoporosis in postmenopausal women in 1997, Evista is currently prescribed to nearly half a million postmenopausal women for bone health. Since both drugs have similar side effects, women who have taken tamoxifen and are looking for agents to improve bone health should find alternatives, such as Fosamax (alendronate) or Actonel (risedronate), in order to avoid increasing the risk of side effects like blood clots.

Tamoxifen is the only Food and Drug Administration-approved drug for breast cancer prevention, but the makers of Evista intend to file the drug for approval for invasive breast cancer risk reduction in postmenopausal women this year. Evista has not been tested in premenopausal women or breast cancer survivors, so tamoxifen is still the only choice for those groups.

For details on the STAR trial, go to www.nsabp.pitt.edu/STAR/Index.asp, and for more on Evista, visit www.evista.com

The Food and Drug Administration approved Dacogen (decitabine), an injection therapy for myelodysplastic syndromes (MDS), in early May after trial results showed Dacogen reduced the number of abnormal cells invading the bone marrow and renewed normal function of blood cells in up to half of patients. Now the third drug approved for MDS in the past two years, Dacogen joins Vidaza (azacitidine) and Revlimid (lenalidomide) for treating the bone marrow disease, which is diagnosed in an estimated 7,000 to 12,000 Americans each year.

The approval was based in part on results from a trial comparing Dacogen with supportive care for patients with intermediate or high-risk MDS. The trial found that 17 percent of patients had a response to treatment, more than half of which were complete hematologic responses (blood counts returned to normal). Thirty-nine percent of patients treated with Dacogen became transfusion independent, and mortality and leukemia risk decreased. Furthermore, most responses were seen within three months of treatment (two cycles of therapy), though a different study found repeated treatments necessary. Common side effects of Dacogen include neutropenia and thrombocytopenia.

In normal cells, tumor suppressor genes and proteins serve as cellular guardians that ensure normal cellular functioning and growth. In MDS cells, many of these tumor suppressors have been silenced, allowing abnormal growth. Dacogen restores tumor suppressor function, allowing them to recognize abnormal growth and restore normal functioning of the cell.

For more information on Dacogen, visit www.dacogen.com

Continue the conversation on CURE’s forum. >>
Talk about this article with other patients, caregivers, and advocates in the CURE discussion group.

Related Articles

1
×

Sign In

Not a member? Sign up now!
×

Sign Up

Are you a member? Please Log In