From OncoLog, Feburary/March 2005, Vol. 50, No. 2/3
In Brief: Research News from the Laboratories and Clinics of M. D. Anderson
Chemotherapy may be unnecessary for rare breast cancer
Recent study results show that women with invasive lobular carcinoma often have a poor response to preoperative chemotherapy. Surprisingly, though, this does not predict a poor prognosis in these women.
“We were very surprised to find that chemotherapy treatment is not necessary to ensure a good prognosis in these women,” said the study’s lead author, Massimo Cristofanilli, M.D., an associate professor in the Department of Breast Medical Oncology at M. D. Anderson.
The study, published in the January issue of the Journal of Clinical Oncology, reviewed six different clinical trials with a total of 912 women with invasive lobular carcinoma and 122 with invasive ductal carcinoma (the most common form of breast cancer). Invasive lobular carcinoma accounts for 5% to 15% of breast cancers.
Both forms are currently treated with chemotherapy prior to surgery to reduce the size of the tumor. This also allows physicians to determine whether a patient responds to a particular chemotherapy drug, in the event that it is needed in follow-up care after surgery.
But now, Dr. Cristofanilli’s study has shown that patients with invasive lobular carcinoma who were not helped by chemotherapy actually had a better long-term outcome than women with invasive ductal carcinoma who had a seemingly good response to chemotherapy.
“We have always thought that a poor response to chemotherapy indicated a worse prognosis, but this study shows that is not true,” he said. “In fact, these results suggest women with invasive lobular carcinoma have a different kind of disease and may benefit from a treatment that is more adequately tailored to the biology of their cancer.
“Before this study, I don’t think anyone realized the disease should be treated differently,” Dr. Cristofanilli said. “Now we need to think about revising our clinical approach and, more importantly, the way we communicate prognoses to women with lobular cancer that has shown poor response to chemotherapy.”New tool aids in bladder cancer screening
Physicians now have a more dependable, less expensive tool to help detect bladder cancer. Researchers at M. D. Anderson found that a simple test that can be administered and read in the doctor’s office is three times more effective than cytology, the conventional laboratory test for detecting bladder cancer.
In a study published in the February 16 issue of the Journal of the American Medical Association, researchers demonstrated that the NMP22 tumor marker assay was significantly more sensitive in screening for bladder cancer than cytology, said Dr. H. Barton Grossman, M.D., professor in M. D. Anderson’s Department of Urology and the study’s lead author. The NMP22 test can be read in the office within 30 to 50 minutes.
“This test is easy and may save lives,” said Dr. Grossman. He cautioned, however, that NMP22 should not be used alone to detect bladder cancer, but should be combined with cystoscopy to provide an accurate diagnosis. “No single procedure is 100% sensitive, so a combination of procedures is recommended,” Dr. Grossman said.For more information on this topic or for questions about M. D. Anderson’s treatments, programs, or services, call askMDAnderson at (877) MDA-6789.
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