Research Notes
WCP carves niche in breast cancer research
Ever since the discovery in 1998 that a "designer" drug, Herceptin, shuts down the growth of many breast tumors with amplification of the HER-2/neu gene, researchers in the Women's Cancers Program at Dana-Farber have mounted one of the world's most extensive efforts to study and improve treatments for women with this type of breast cancer.
About 20–25 percent of breast tumors are "HER-2-positive," in which an overproduction of the HER2 protein spurs the breast cells into uncontrolled, aggressive growth. Over the past seven years, Women's Cancers Program investigators have led nearly a dozen clinical trials of new therapies for such cancers, while exploring how these therapies affect cells' basic molecular functioning.
"We've taken a very comprehensive approach to HER-2-positive breast disease, extending from basic science investigations to multiple clinical studies," says Eric Winer, MD, director of the Breast Oncology Center at Dana-Farber. "Small, initial studies that we've undertaken have led to larger studies that may help thousands of women nationwide."
WCP researchers have completed two trials of Herceptin and chemotherapy given prior to breast cancer surgery – enabling researchers to study the effect of the drugs on the tumor cells – and are currently conducting a third. The Dana-Farber/Brigham and Women's Cancer Center also participated in a landmark study showing that Herceptin given along with chemotherapy lowered the risk of recurrence by 52 percent compared with chemotherapy alone.
In addition, WCP researchers have tested several combinations of Herceptin with various chemotherapy agents, including a trial with National Cancer Institute researchers of Herceptin and epothilone b, an experimental drug similar to paclitaxel (Taxol). Finally, WCP researchers have recently completed a clinical study of lapatinib, a new drug, for HER-2-positive cancers that have spread to the brain.
Program for Young Women with Breast Cancer up and running
In the United States, breast cancer is the most common type of cancer and the second leading cause of cancerrelated death in women. Yet, little is known about breast cancer in women 40 and under.
As part of a larger effort to better understand this disease and to improve care and outcomes for younger patients, Dana-Farber has developed a program for this age group.
Being diagnosed with breast cancer can raise many questions during or after treatment. Through this program, DFCI provides comprehensive and consistent quality care dedicated to the concerns and issues that younger patients face. The program incorporates all aspects of care, placing emphasis on the issues unique to younger women living with and beyond this disease. For more information about the program, call (617) 632-1924.
Hot flash and insomnia studies
Many breast cancer patients experience hot flashes. For some, serotonin-based drugs like Effexor (venlafaxine), Paxil (paroxetine), and Prozac (fluoxetine) minimize their symptoms. For 40 percent of women, however, these medications fail to provide relief. In this clinical study, researchers hope to learn if adding a sleeping aid will improve the benefits of these medications.
Women 18–65 who are awakened at night by hot flashes are eligible to participate in the study if they are taking tamoxifen, Evista (raloxifene), Femara (letrozole), Arimidex (anastrazole), Aromasin (exemestane), GnRH agonists, or have had both ovaries removed. They must be free of medications for hot flashes, but can already be taking a serotonin-based drug.
The study involves five weeks of treatment with one of two alternatives: Effexor with the sleeping aid Ambien (zolpidem), or Effexor with a placebo. Women already taking a serotonin-based drug will continue that medication and Ambien, or a placebo will be added. Participants will have their hot flashes and sleep measured before and after treatment with equipment that they wear in their own homes.
In addition, researchers are investigating what goes on in the brain when women develop hot flashes on aromatase inhibitors by examining PET scans. For more information about either study, contact research coordinator Jeremy Whyman at (617) 632-6341.
