New Approach May Boost Survival From Advanced Prostate Cancer

Adding generic docetaxel to standard hormonal treatment seems to have benefit, study shows

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

SUNDAY, June 1, 2014 (HealthDay News) -- Adding the chemotherapy drug docetaxel to standard hormone-depleting therapy may extend the lives of men with advanced prostate cancer, a new study finds.

The study was to be presented Sunday in Chicago at the annual meeting of the American Society of Clinical Oncology (ASCO).

"Hormone therapy has been a standard treatment for prostate cancer since the 1950s," lead author Christopher Sweeney, a medical oncologist at the Dana-Farber Cancer Institute in Boston, explained in an ASCO news release.

"This is the first study to identify a strategy that prolongs survival in newly diagnosed metastatic prostate cancer," he added. "The benefit is substantial and warrants this being a new standard treatment for men who have [extensive] disease and are fit for chemotherapy."

One expert not connected to the new trial agreed.

"These data are practice-changing and help us further improve the care we give to patients with prostate cancer," said Dr. Arjun Balar, co-leader of the Genitourinary Cancers Program at the Perlmutter Cancer Center at NYU Langone Medical Center in New York City.

He believes the study will "also help us better understand the biology of the most aggressive and lethal prostate cancers so we can design new clinical trials to further improve the outcomes of men with this devastating disease."

Prostate cancer is often spurred on by hormones such as testosterone, so hormone-depleting therapy is the standard initial treatment for these "hormone-sensitive" tumors. The treatment is initially effective, but the disease eventually becomes resistant to the therapy in most patients.

Chemotherapy is typically started only after the disease progresses despite hormone therapy, experts note.

In this U.S. National Cancer Institute-led study, 790 men newly diagnosed with advanced hormone-sensitive prostate cancer were divided into two groups. One group received hormone therapy alone, while the other group got hormone therapy plus docetaxel for 18 weeks.

After a median follow-up of more than two years, there were 136 deaths in the hormone therapy-only group, and 101 deaths in the hormone therapy-plus-docetaxel group. Median survival was 44 months in the hormone therapy group and 57.6 months in the hormone therapy/docetaxel group, the researchers reported.

Among men whose prostate cancer had spread to major organs or bones, median survival was 32.2 months in the hormone therapy group and 49.2 months in the hormone therapy/docetaxel group.

The use of docetaxel also delayed cancer progression, the study found. Median time to progression after treatment was 19.8 months in the hormone therapy group and 32.7 months in the hormone therapy/docetaxel group.

"These results demonstrate how we can use 'old tools' in new, more powerful ways to improve and extend patients' lives," ASCO President Dr. Clifford Hudis said in the ASCO news release.

"This study is also a powerful testimony to the importance of National Cancer Institute-led research, as both of these drugs are available in generic form today and this research might have otherwise not been pursued," he added.

Experts caution that studies presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

source : New Approach May Boost Survival From Advanced Prostate Cancer

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Newer Anti-Estrogen Treatment May Benefit Younger Breast Cancer Survivors

Drug appears more effective than tamoxifen at reducing recurrence in premenopausal women: study

WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

SUNDAY, June 1, 2014 (HealthDay News) -- A new type of anti-estrogen drug appears to work better than the estrogen-blocking drug tamoxifen in preventing recurrences of breast cancer in certain women, a new study reports.

Exemestane (Aromasin), which belongs to a class of drugs called aromatase inhibitors, reduced the relative risk of breast cancer recurrence by nearly a third compared to tamoxifen. But, for exemestane to work in premenopausal women, the drug can only be given when ovarian function is being suppressed.

"For years, tamoxifen has been the standard hormone therapy for preventing breast cancer recurrences in young women with hormone-sensitive disease. These results confirm that exemestane with ovarian function suppression constitutes a valid alternative," study lead author Dr. Olivia Pagani, clinical director of the Breast Unit at the Oncology Institute of Southern Switzerland in Bellinzona, Switzerland, said in a prepared statement.

Findings from the study were scheduled to be presented Sunday at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago. The study was also published simultaneously in the New England Journal of Medicine. Funding for the study was provided by drug makers Pfizer and Ipsen, as well as the International Breast Cancer Study Group and the U.S. National Cancer Institute.

Aromatase inhibitors, such as exemestane, work by preventing other hormones from changing into estrogen, which is the female hormone that often fuels breast cancer growth.

By comparison, tamoxifen blocks estrogen from being used by cancer cells.

Tamoxifen has been the default standard of care for premenopausal women because aromatase inhibitors are not effective in women whose ovaries are functioning, said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society.

"The amount of estrogen in their bodies is too great for it to have a beneficial function," Lichtenfeld said.

But doctors wondered whether aromatase inhibitors could be used to better protect young women against breast cancer if their ovary function was suppressed, essentially putting them through menopause and reducing their estrogen levels.

This study analyzed treatment outcomes of almost 4,700 breast cancer survivors who participated in two worldwide clinical trials aimed at answering that question.

The women, average age 43, all underwent treatment to stop their ovaries from functioning. Each chose one of three methods, Lichtenfeld said -- they could take medication to suppress ovary function, have their ovaries exposed to radiation, or have their ovaries surgically removed.

On top of ovary suppression, the women were randomly assigned to take either exemestane or tamoxifen to help prevent a recurrence of their breast cancer.

The cancer-free survival rate at five years ended up 91.1 percent in the exemestane group versus 87.3 percent in the tamoxifen group. That amounts to a 28 percent lower risk of subsequent invasive cancer, the researchers reported.

source : Newer Anti-Estrogen Treatment May Benefit Younger Breast Cancer Survivors

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Expert Q&A: Pet Flea and Tick Control

By Betsy Riley
WebMD Feature

Reviewed by Amy Flowers, DVM

With so many new flea and tick control products, it’s hard to know which one is right for your pet. Here’s some advice from Ira Roth, DVM, director of the Community Practice Clinic at the University of Georgia’s College of Veterinary Medicine.

Are some flea and tick medicines better than others?

Every vet has favorites, and all the products work in different ways. Sometimes they kill just adult pests, and sometimes they kill eggs and larvae, too. Some work against fleas, ticks, and even heartworms. Others work against just one species. It’s really a matter of what type of protection each pet needs, the easiest way for the owner to apply it, and budget.

What's the right way to apply drops (aka "spot-on treatments")?

Generally, you apply the medicine between your pet’s shoulder blades, on the back of the neck. Make sure to part the hair so the liquid goes on the skin, and not just on top of the fur. Because the pesticide can be toxic, wait up to 24 hours while the liquid dries before touching the area or letting children play with the animal. Be sure to use the right dose for the age and size of your pet. Follow directions carefully, and never use dog products on cats. Some pesticides that are safe for dogs can even kill cats.

Are spot-on treatments dangerous?

In 2010, the Environmental Protection Agency ordered manufacturers to put better instructions on packages when the number of bad reactions jumped dramatically -- often because pet owners used drops incorrectly. However, the EPA did not recall any products. Individual pets can have problems with any type of flea or tick medicine. The main thing is to ask your vet for an appropriate medicine and to follow the instructions.

Are pills a better idea?

It’s really a matter of preference. Pills may give a few pets an upset stomach or even cause vomiting or diarrhea, so it’s a good idea to give them with food. There are a number of really good products, some in combination with heartworm control. Before, we did not have an oral product that controlled ticks, and now they’ve introduced a chewable, beef-flavored tablet for dogs that helps with both flea and tick control.

How effective are flea and tick collars?

Collars may actually be the best way to control ticks. There a couple of new collars on the market that last 6 or 8 months. They don’t have the terrible odor and greasiness associated with the old-style models, and we’re getting really good feedback from clients. They control both ticks and fleas.

What about dips, powders, sprays, and shampoos?

Those products are not as effective as the longer-acting ones because you have to use them so often and it’s hard to keep up.

source : Expert Q&A: Pet Flea and Tick Control

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