The Lynx Group

March 2013, Highlights

A new meta-analysis confirmed that patients with breast cancer who achieve a pathologic complete response (pCR) to neoadjuvant therapy have a more favorable outcome than those who do not.
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Observational studies have sug­gested that the antidiabetes agent metformin (Glucophage) may have anticancer effects. New studies have attempted to confirm this, but the results and their meaning still remain unclear.
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More evidence is accumulating that vitamin D levels play a role in breast cancer outcomes. Investigators from the United Kingdom reported that postmenopausal women with sufficient vitamin D levels were significantly less likely to develop bone metastases when taking zoledronic acid (Zometa) compared with women with lower vitamin D levels.
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The antidepressant venlafaxine (Effexor) is often prescribed to patients with breast cancer who are taking tamoxifen (Nolvadex) to help reduce the side effect of hot flashes. But according to research presented at the meeting, venlafaxine may reduce the effectiveness of tamoxifen.
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Histone deacetylase (HDAC) inhibitors may have a future in the targeted treatment of triple-negative breast cancer, if the results of in vitro studies can be replicated clinically.
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Although many clinicians are already prescribing fulvestrant (Faslodex) at a dose of 500 mg, a phase 3 study presented at the meeting confirmed the superiority of this dose over 250 mg.
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A comparison of letrozole (Fem­ara) with tamoxifen (Nolva­dex) demonstrated that the former may be superior for the treatment of postmenopausal estrogen receptor (ER)-positive patients who have lobular carcinoma, according to a subanalysis of patients in the phase 3 BIG 1-98 trial.
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Black women and other racial minorities are less likely than white women to receive sentinel lymph node (SLN) dissection as the standard of care for clinically node-negative breast cancer, and this has negative consequences, an analysis of the Surveillance, Epidemiology and End Results (SEER)/Medicare database suggested.
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Axillary lymph node dissection (ALND) may not be necessary after neoadjuvant chemotherapy in most patients, according to investigators who found that sentinel lymph node (SLN) dissection correctly staged more than 90% of patients.
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In making decisions about adjuvant chemotherapy, biologic subtype has replaced nodal status and tumor size as parameters to consider, although subtype—and tests that define them—are still insufficient for the provision of optimal care, said Antonio C. Wolff, MD, Professor of Oncology at Johns Hopkins University School of Medicine, Baltimore.
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