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Our Cover Story: Treatment for late stage disease Ask the Expert: Larry Norton, MD S & C Profile: Eileen Kastura Calendar of Events
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Autumn 2011 A NEWSLETTER FOR BREAST CANCER SURVIVORS
The U.S. Food and Drug Administration approved Halaven (eribulin mesylate) to treat patients with metastatic breast cancer who have received at least two prior chemotherapy regimens for late-stage disease.
Metastatic breast cancer refers to cancer that has spread to distant sites in the body. Treatment of metastatic breast cancer often includes chemotherapy, but options can become limited when the cancer stops responding to conventional chemotherapy regimens.
Halaven is a synthetic form of a chemotherapeutically active compound derived from the sea sponge Halichondria okadai. This injectable therapy is a microtubule inhibitor, believed to work by inhibiting cancer cell growth. Before receiving Halaven, patients should have received prior anthracycline-and taxane-based chemotherapy for early or late-stage breast cancer.
The EMBRACE study is a Phase III clinical trial that contributed to approval of Halaven. Study participants were randomly assigned to receive either Halaven or treatment of physicians choice. Because there is no single standard treatment regimen for women at this stage of breast cancer, treatment of women in the comparison group was left up to the patients physician. Halavens safety and effectiveness were established in a single study in 762 women with metastatic breast cancer who had received at least two prior chemotherapy
regimens for late-stage disease.
The study was designed to measure the length of time from when this treatment started until a patient's death (overall survival). The median overall survival for patients receiving Halaven was 13.1 months compared with 10.6 months for those who received a single agent therapy.
The results of this study suggest that Halaven can extend life among women with advanced, heavily pretreated breast cancer.There are limited treatment options for women with aggressive forms of late-stage breast cancer who have already received other therapies, said Richard Pazdur, M.D., director of the Office of Oncology Drug Products in the FDAs Center for Drug Evaluation and Research. "Halaven shows a clear survival benefit and is an important new option for women."
Other FDA-approved therapies used to treat late-stage, refractory breast cancer include Xeloda (capecitabine) for patients with breast cancer resistant to paclitaxel and anthracycline-containing chemotherapy; Ixempra (ixabepilone) for patients with late-stage disease after failure of an anthracycline, taxane and Xeloda; and Ixempra plus Xeloda for patients with late-stage disease after failure of anthracycline and taxane-based chemotherapy.
Reprinted from the FDA.gov and ww5.komen.org Results of the EMBRACE study were publish in The Lancet, 3/3/2011
News About Breast Cancer
NEW TREATMENT FOR LATE STAGE DISEASE
Fall is in full swing, and the chilly weather has arrived. While most of us have no problem feeling the chill in the air, those with peripheral neuropathy may. Neuropathy can be an unwelcome side effect from chemotherapy and can be transient but still a challenge to manage. We welcome medical oncologist Dr. Laura Nadeau on October 6th at 7pm at Troy Beaumont to enlighten us on what exactly neuropathy is and how to prevent/manage it.
This year, S&C has started a new support group for women with metastatic breast cancer. Personally, I have become very fond of these ladies. They are living their lives to the fullest (something we should all be doing!) and managing medical challenges as they arise. Unfortunatley, the breast cancer community tends to keep these ladies at
an arms distance, and the focus is on curable breast cancer in October. With this being said, I am happy to invite ALL OF YOU to a celebration of life and awareness on October 13, Metastatic Breast Cancer Awareness Day. We will have several wonderful speakers: Dr. Nayana Dekhne Director of the Comprehensive Breast Clinic, Jennifer Martens, R.N. Oncology Nurse manager, Debra Luria Ph.D, A.P.R.N, Clinical Psychologist and survivor and my dear friend Eileen Kastura, a three year metastatic survivor. We will meet in the lovely Salisbury Garden at Royal Oak Beaumont at 3pm for tea (light snacks) and talk! Please RSVP, so we can be assured to have enough food and drink available for the celebration.
Living DownstreamWalking Upstream A Movie Night brought to us by the Michigan Breast Cancer Coalition. This powerful documentary revolves around Sandra Steingraber, Ph.D when she receives a cancer diagnosis. She then begins to research and uncover some of the possible enviormental causes of cancer. Sandras personal story about her cancer journey and her discoveries is a night not to be missed! This movie viewing will be held at the PNC Bank Building in Troy.
Volunteers are a big part of what makes S&C successful. Please join us for a volunteer appreciation night December 8th! If you have volunteered for us or are interested in volunteering come join us the night for a light meal, friendship, sharing and a big thank you from us!
Have a wonderful Fall and Holiday Season!warm regards, Lorelei
Sharing & Caring is a non-profit organization dedicated to confronting breast cancer with
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Greetings from Lorelei
Often women with Stage IV breast cancer feel like outsiders. Attention and focus is given to women whose breast cancer is "curable." Are there any initiatives underway across the U.S. to bring more attention to women who are living with breast cancer day in and day out? Dr. Norton: The comment is absolutely right. A lot of the communication and resources are focused on patients with primary breast cancer rather than recurrent breast cancer. However, there are efforts to correct that. One of the major changes in metastatic breast cancer over the years is conversion from an acute fatal disease to a chronic one that people can live with. I have people with metastatic breast cancer that I've cared for for 25 years. I expect that we're going to see more and more people with long survival with this disease, which is always a prelude towards disease cure. I suspect we're in that transition now. Dr. Weiss: New therapies for breast cancer are usually first introduced in clinical trials for women with metastatic disease, so women with metastatic disease truly are pioneers for new treatments and approaches in the future. I have mets to my liver and bones, and because most of the time I look great, people assume I am great when really I feel like crap and am tired. When they say, "Wow, you look so normal," it is so hard to not break down and cry and yell at them. What can I do? Dr. Norton: Basically, you need somebody to talk to about your own individual psychological situation and relationship to this illness. Many people need some individual counseling - not because you're ill or you're doing things wrong, but to gain coping skills so psychologically you can do as well as you seem to be doing physically. Dr. Weiss: Often people will take their cue from you. So if you are looking glamorous, strong, and courageous, people will want to assume that you are everything that you seem plus more. Dealing with expectations your own, as well as others is one of the challenges of living with metastatic breast cancer. Ideas from a therapist can be quite helpful in this situation. It seems to me that women with Stage IV cancer on clinical trials face a great deal of uncertainty regarding effectiveness of their treatment. Are there particular/specific ways of helping these women cope with day-to-day living on clinical trials? Dr. Norton: Uncertainty is part of life and if you have a serious disease, that uncertainty is heightened. Being on a clinical trial in many ways reduces that uncertainty since the schedule of testing for the status of the disease is determined by experts and adhered to carefully. It is very important when one has a serious disease to do everything possible to do well with that disease, including establishing a relationship with a doctor or nurse with whom you have a great deal of trust. When you are doing everything you can to do well, then you should turn your attention to living as full a life as possible. It is a mistake to become a professional patient. Your illness is only one part of your life; the other parts of your life also deserve your attention and respect. Make decisions and go on with your life. Enjoy the people that you love. And that's the best way to reduce fear. Dr. Weiss: Dr. Norton taught me a long time ago that there's only one of each of you, and each pe