Resveratrol and BRCA mutations

A number of studies have suggested that a substance found in red grapes and red wine may serve as a cancer preventive. Now research outlines a mechanism whereby inherited BRCA mutations, which occur in about 8% of breast cancers, may be inhibited by resveratrol.

New Findings May Improve Treatment Of Inherited Breast Cancer
(from ScienceDaily Oct. 11, 2008, published in the journal Molecular Cell)

This research in animals and cell cultures will have to be confirmed in human subjects, of course. Initial studies are underway looking at a cancer preventive role for resveratrol in health subjects, as well in colon cancer and lymphoma patients.

--Musa

Bone mets pain and IV Bisphosphonates--what is the evidence?

Here's a just-published survey of studies on various methods for the relief of the pain of bone mets, available in full text. Metastatic bone pain: treatment options with an emphasis on bisphosphonates is by a group of Swiss researchers, and is published in the journal Supportive Care in Cancer.

What I find interesting is this article's focus on the available evidence for the use of IV bisphosphonates, Aredia (pamidronate) and Zometa (zoledronic acid) for the relief of pain. Taking one of these two drugs is the recommended standard of care for all women with bone mets--although optimal frequency is still unclear, because of osteonecrosis of the jaw (ONJ) in some patients.

Today, painful broken bones and the surgeries to repair them are far less common than they were a decade ago. Very high levels of calcium dissolved into the blood, known as hypercalcemia, are no longer a frequent late complication.

Now, evidence from many randomized controlled trials confirms that these drugs also help to reduce bone pain. Of course, women have been telling us this for years!

Musa

Welcome and metronomic therapy

I'm Musa Mayer, advocate and author. I've just re-launched my website AdvancedBC.org with lots of new information and resources for people living with metastatic breast cancer, gathered on one convenient website. In this blog, I'll be sharing new research and treatment information about metastatic breast cancer as it emerges.

The most intriguing research I've seen in the last couple of weeks was a low-dose metronomic treatment study in 46 Italian women with metastatic disease. In this study patients were given low-dose Xeloda and Cytoxan on a daily basis, combined with Avastin every three weeks. Two-thirds of patients showed clinical benefit, with either their tumors shrinking or their disease stabilizing for at least six months. It's a small study, but promising. Write me for the full text of this paper.

Metronomic Cyclophosphamide and Capecitabine Combined With Bevacizumab in Advanced Breast Cancer
Silvia Dellapasqua, Marco Colleoni et al.
Journal of Clinical Oncology 26, 2008

Purpose. Metronomic chemotherapy has shown efficacy in patients with metastatic breast cancer. When used in association with targeted antiangiogenic drugs, it was more active than metronomic therapy alone in preclinical and clinical studies.

Patients and Methods. Patients with advanced breast cancer were candidates to receive metronomic oral capecitabine (500 mg thrice daily) and cyclophosphamide (50 mg daily) plus bevacizumab (10 mg/kg every 2 weeks).

Results. In 46 assessable patients, we observed one complete response (CR; 2%), 21 partial responses (PR; 46%), 19 patients (41%) with stable disease (SD), and five patients (11%) with progressive disease, for an overall response rate of 48% (95% CI, 33% to 63%). Additional long-term disease stabilization (SD
24 weeks) occurred in eight patients, for an overall clinical benefit (CR+PR+SD=24 weeks) of 68% (95% CI, 51% to 81%). Median time to progression was 42 weeks (95% CI, 26 to 72 weeks). Toxicity was generally mild. Grade 3 or 4 nonhematologic adverse effects included hypertension (n 8), transaminitis (n 2), and nausea/vomiting (n 2). Higher baseline circulating endothelial cells (CECs) were correlated with overall response (P .02), clinical benefit (P .01), and improved progression-free survival (P .04).

Conclusion. Treatment with metronomic capecitabine and cyclophosphamide in combination with bevacizumab was effective in advanced breast cancer and was minimally toxic. The number of baseline CECs significantly correlated with response and outcome, therefore supporting further studies on this surrogate marker for the selection of patients to be candidates for antiangiogenic treatments.

--Musa