Oncology

Specialty Pharmacy Times, June 2012, Volume 3, Issue 3

Gene Research May Reclassify Breast Cancers

Scientists from the UK’s Cambridge Research Institute have published a global gene study of breast cancer tissue that may reclassify the disease into 10 new categories based on the genetic fingerprint of the tumor.

The study, published in the journal Nature, is the largest of its kind. Researchers analyzed the DNA and RNA of 2000 tumor samples from women diagnosed with breast cancer 5 and 10 years ago. By analyzing the tumor’s genetic profile, researchers predict, new drugs can be designed that target unique mutations found in the tissue DNA.

Beyond the classifications of estrogenreceptor positive and HER2 positive, the current study will reclassify breast cancer into 10 types, changing the face of breast cancer as we know it. With the new classification system, clinicians will be able to identify breast cancer not only by the presence of certain receptors but also by the quantity of the receptors found in the tumor. For example, some tumors may be more robustly HER2- positive than others. In addition, the new classification schema will take into consideration whether completely new markers are present, such as certain kinases and phosphatases. It will also elucidate more on the triple-negative type of breast cancer, further classifying it based on which markers are present.

“This study is another building block in our goal for women to receive personalized, tailor-made treatments specific to their particular type of breast cancer, rather than just a one-size-fits-all treatment approach,” Julie Wilson, PhD, head of research at Breakthrough Breast Cancer in the United Kingdom, said in a statement.

Lifestyle Changes Could Cut Cancer Rates

On April 19, 2012, the American Cancer Society (ACS) released its annual report, which included changes that policy makers can make to foster healthier lifestyle choices and potentially cut cancer rates in the United States.

The report noted that although cancer deaths in the United States continue to decrease due to better screening and advances in treatment, cases linked to obesity and inactivity seem to be increasing. In fact, the ACS reported that being overweight and inactive may be risk factors for one-fourth to one-third of common cancers. “After tobacco use,” the report states, “the major risk factors for cancer are obesity, lack of exercise, and poor eating habits.” The ACS recommends that public, private, and community organizations work together to encourage healthy eating and increased physical activity.

Although it is encouraging that tobacco use has continued to decrease and recommended screenings and rates of vaccination have increased, rates of obesity and inactivity have unfortunately continued to grow.

The ACS recommends some key strategies in order to decrease obesity and increase physical activity, such as strengthening nutritional standards for foods and beverages that are part of school meals, increasing access to affordable healthy foods in the community, investing in community redesign efforts that support the development of sidewalks and access to parks and green space, and encouraging collaboration among numerous sectors. The full report, as well as all of the ACS’s recommendations, can be found at www.cancer.org.

Chemoradiation Best Option for Advanced Bladder Cancer

A new study demonstrates that the best option for patients with advanced bladder cancer is a combination of chemotherapy and radiation.

The study, published April 19, 2012, in the New England Journal of Medicine, was a multicenter, phase 3 trial that randomly assigned 360 patients into groups receiving radiation alone or radiation plus chemotherapy. The primary end point was survival free of locoregional disease. Secondary end points included overall survival and toxic effects.

The researchers found that those who received a combination of radiation and chemotherapy had a 67% rate of diseasefree survival after 2 years compared with 54% in the radiation group. The 5-year survival rates were 48% in the chemoradiation group compared with 35% in the radiation-only group. The chemotherapy used and recommended for bladder cancer is a combination of fluorouracil and mitomycin C, 2 relatively inexpensive drugs with minimal side effects.

SPT

Fast Fact: The American Cancer Society estimates that 241,740 new cases of prostate cancer will be diagnosed in 2012.

About the Author

Michael C. Wisotsky, PharmD, RPh, practices in Shrewsbury, New Jersey.