Tailored Chemotherapy For All? from BCAG Newsletter Nov 2006

Many people give their time in different ways to improve conditions for the breast cancer community. Here we can discuss what's happening and what needs to happen. We can also celebrate the successes, acknowledge the input and learn how we can help or become involved.
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Janine
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Tailored Chemotherapy For All? from BCAG Newsletter Nov 2006

Postby Janine » Mon Jan 08, 2007 1:10 am


BREAST CANCER ACTION GROUP NEWSLETTER ISSUE NUMBER 66

Tailored Chemotherapy For All?
A new study looks at which chemo is most suited to the individual
We have mentioned the advent of micro array assays, biomarkers, genomic profiling and other ways of trying to determine which drugs are most likely to work for a particular person’s tumour. Some of these are already with us (eg oestrogen receptors for tamoxifen, Her 2 receptors for Herceptin) but many more are in the pipeline. The main benefit for us is that when these are proven and accessible, they will be tools for selecting which chemotherapies our particular cancer will respond to. This will obviate the “hit and miss” situation in which women and their medical oncologists often find themselves. It might also provide a substantial cost saving to the public purse – specific drugs could eventually be used only in those most likely to benefit.

The aim of recent work is to develop genomic predictors of chemotherapy sensitivity to indicate which cytotoxic agents are most likely to cause a particular tumour to respond. This was the purpose of a major piece of work by Anil Potti and investigators from Duke University, USA, published in Nature Medicine (Nov 2006). The article is titled “Genomic signatures to guide the use of chemotherapeutics”. The authors find “…...that individual signatures can accurately predict response to drugs in both the neoadjuvant and adjuvant chemotherapy settings….”.

“Ultimately we suggest that future treatment strategies might be based on an analysis of an individual’s tumour, which would then allow the development of a profile of likely sensitivity to common therapeutic drugs as well as to targeted therapies. Based on this information each individual might then be assigned to a combination regime that best matches the profile from the tumour”.

The authors recommend that “prospective validation studies are, however, needed to confirm the effectiveness of this approach” and that clinical trials should be set up to evaluate the performance of a random selection of agents.

An advocacy opportunity?
BCAG NSW believes this is a development which as it progresses, we should watch carefully. While they may be some time off the benefits could apply to many of us, now that chemotherapy is widely offered at most stages of breast cancer. Clinical trials may need to be funded by governments, as there will be little foreseeable gain for the pharmaceutical companies (less chemo products would ultimately be used).

Watch this space!
For next newsletter, we will ask one or two well known medical oncologists to comment on these initiatives so we have the considered professional view of where things are moving, at what speed and what the impact may be for us.
Sally Crossing (NSW)

[BCAG produces a great newsletter. It is always very interesting and contains important information.
BCAG has very kindly allowed parts of their newsletter to be reproduced here.]
Janine

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