Progress Against Breast and Gynecologic Cancers: Highlights from ASCO

Advances in the treatment of cancers that primarily affect women, including breast and gynecologic cancers, were presented in Orlando at the 45th Annual Meeting of the American Society of Clinical Oncology (ASCO), the world’s leading professional organization representing physicians who care for people with cancer.

“Studies presented during the 45th Annual Meeting of the American Society of Clinical Oncology demonstrate continued progress against breast, ovarian and cervical cancers, which are major causes of cancer mortality worldwide,” said Eric P. Winer, MD, Chair of ASCO’s Cancer Communications Committee and professor of medicine at Harvard Medical School. “One study tells us that women can safely avoid unnecessary blood tests and can delay toxic treatment for ovarian cancer recurrence without compromising their longevity. Others report on a promising new class of targeted drugs for some of the most difficult-to-treat breast cancers. And others provide more effective and less invasive options for treating cervical cancer, which is a particularly significant problem in developing countries.”

Studies highlighted during ASCO include:

• No survival advantage to treating ovarian cancer relapse based on rising CA125 levels, compared with waiting for symptoms. A study featured in ASCO’s plenary session reports that starting treatment immediately for an ovarian cancer relapse based on CA125 protein levels found in the blood does not improve overall survival, compared with delaying treatment until symptoms arise. The findings should allow women to avoid the anxiety and cost associated with frequent blood testing and the toxicity of early treatment.
• PARP inhibitors show promise for hard-to-treat breast cancers. Two studies, including one featured in ASCO’s plenary session, report promising data on a new class of targeted drugs called PARP inhibitors. Poly (ADP-ribose) Polymerase (PARP) has a well-established role in DNA repair processes, and small molecule inhibitors of PARP have been developed as chemotherapy sensitisers for the treatment of cancer. The subsequent demonstration that PARP inhibition is selective for BRCA1 or BRCA2 deficiency suggests that PARP inhibitors may be particularly useful for the treatment of cancer with BRCA mutations. The plenary study reports that women with hard-to-treat “triple-negative” breast cancer who received the PARP inhibitor BSI-201 (BiPar Sciences Inc) along with conventional chemotherapy had 60% better survival outcomes compared with chemotherapy alone than women who received chemotherapy alone. A second study reports that women with BRCA-deficient advanced breast cancer experienced tumor shrinkage after receiving the PARP inhibitor olaparib as a single agent.
• Gemcitabine plus chemoradiation improves cervical cancer survival. Adding the drug gemcitabine (Gemzar) to cisplatin-based chemotherapy and radiation therapy extends overall survival among women with locally advanced cervical cancer. This study was primarily conducted in developing countries, where cervical cancer screening programs are limited.
• Sentinel node biopsy is an effective option for early-stage cervical cancer. Most women with early-stage cervical cancer can safely undergo sentinel node biopsy – a technique in which only one or two lymph nodes are removed to determine whether cancer has spread – in lieu of the traditional, more invasive pelvic lymph node removal, which can lead to more significant side effects. Sentinel node biopsy was also as effective for detecting cancer spread to atypical areas of the pelvis.

For more information, read these PubMed abstracts

• Sivanesaratnam V. Third S. S. Ratnam Memorial Lecture 2007. Ovarian cancer: Is there hope for women? J Obstet Gynaecol Res. 2009 Jun;35(3):393-404.
• Gupta D, Lis CG, Vashi PG, Lammersfeld CA. Impact of improved nutritional status on survival in ovarian cancer. Support Care Cancer. 2009 May 31. [Epub ahead of print]
• Turgut O, Tandogan I, Yilmaz MB, Gul I, Gurlek A. CA125 levels among patients with advanced heart failure: An emerging independent predictor for survival. Int. J Cardiol. 2009 May 13. [Epub ahead of print]
• Interim phase 2 results for PARP inhibitor BSI-201 at San Antonio Breast Cancer Symposium. Cancer Biol Ther. 2009 Jan;8(1):2-3.

Help your patients understand:

• For consumer-oriented information about the studies in this article, please refer your patients to ASCO’s patient website.