Herceptin (trastuzumab) is a targeted therapy used for treatment of HER2 positive breast cancer. Results of a Phase II clinical trial showed that Herceptin might have a roll in treating patients with HER2 positive advanced bladder cancer.

The researchers conducted the clinical trial to examine the effectiveness of Herceptin along with chemotherapy in a little under fifty patients with advanced bladder cancer. The chemotherapy given with the Herceptin was paclitaxel, carboplatin, and gemcitabine.

This was a small study and research will have to continue to see if this treatment is something that will be put into mainstream use. The study concluded that:

• 11 percent of patients experienced a complete disappearance of detectable cancer.
• 59 percent of patients experienced a partial disappearance of detectable cancer.

The Sister Study is a clinical trial that is now enrolling patients to determine what environmental factors and genes play a part in developing breast cancer.

Researchers want to find what causes breast cancer, and through understanding this they can work to prevent the disease altogether. There are some known factors to contribute and or prevent the development of breast cancer -- diet, exercise, hormone therapy, breast-feeding and smoking. However, the prevalence of the disease suggest there are other factors at play that we are not aware of at this time.

Women who fit the following criteria are urged to enroll in the Sister Study and join the fight against this disease:

• A sister related by blood, alive or deceased, diagnosed with breast cancer.
• Ages 35 -74 years.
• Living in the United States or Puerto Rico.

The Sister Study is being conducted by the National Institute of Environmental Health Sciences and will be evaluating women from all backgrounds, occupations, races and ethnicities to attempt to identify environmental and genetic factors that may be associated with affecting the risk of breast cancer.

Cancer on my mind is an article written by Dr. Albert Lim Kok Hooi, a consultant oncologist. He opens his article by saying:

As a doctor, I am interested in how the human mind works. As an oncologist, I am interested in the lure of alternative medicine. And so I have tried to understand why, in spite of all the scientific evidence at hand, there are many amongst us who do not want to undergo conventional cancer treatment – surgery, radiotherapy, chemotherapy and targeted therapy – but instead risk being treated by unproven and potentially dangerous alternative therapies.

He goes on to say that this happens because sometimes science is not very well understood. He talks about confirmed bias, a phenomenon in cognitive science, the science of how the mind works. He describes it as a person that -- notices the hits and ignores the misses in support of his own beliefs. So, basically someone might have a strong bias against chemotherapy, for no other reason than what they have seen on television, without really knowing the true facts.

Axitinib is an agent that targets angiogenesis -- blood supply to a tumor. It disrupts blood vessels that grow and provide nutrients to cancer cells. Without the nutrients and oxygen supplied by blood vessels, cancer cells cannot grow or replicate.

Researchers conducted a trial to evaluate axitinib in the treatment of metastatic breast cancer. Patients were either given Taxotere or Taxotere plus axitinib. Anticancer responses were achieved in 40 percent of patients treated with the addition of axitinib to Taxotere, compared with only 23 percent of patients treated with Taxotere alone.

The researchers concluded -- that the addition of axitinib to Taxotere improves anticancer responses and delays cancer progression compared to Taxotere alone in the treatment of metastatic breast cancer.

A report published in the Journal of the National Cancer Institute has stated that cisplatin has better response rates than carboplatin in the treatment of advanced non-small cell lung cancer.

The two main types of lung cancer, accounting for over 90 percent of all lung cancers, are non-small cell and small cell cancer. Non-small cell lung cancer (NSCLC) accounts for most of that 90 percent.

Advanced NSCLC means that the patient's cancer has spread to other organs or areas of the body. There has been research done to evaluate which drug is better for NSCLC -- cisplatin or carboplatin. Nine clinical trials were analyzed to see what regime is a better treatment option.

Now here's some good news for Tamoxifen-taking, hot-flash suffering women. A new study finds women who have lots of hot flashes during treatment with the breast cancer drug Tamoxifen have a lower risk of recurrence than women who don't suffer from the annoying waves of heat commonly associated with menopause.

"This study provides the first evidence that hot flashes may be an indicator of a better prognosis in women with early stage breast cancer," said study author John P. Pierce, Ph.D., from the University of California at San Diego. "Our data supports the possibility of a significant association between hot flashes and disease outcome."

More study is necessary to determine whether or not hot flashes -- which may predict better outcomes than severity of cancer, hormone receptor status, and age -- are associated with Tamoxifen and breast cancer progression.

Femara (letrozole) is an aromatase inhibitor that works by suppressing the production of estrogen. In postmenopausal women estrogen is still produced in the body by the adrenal gland. Decreasing this production is a way of decreasing the risk of recurrence.

Tamoxifen on the other hand works by blocking the estrogen receptors on the cancer cell itself resulting in slower growth of the cell or cell death. Tamoxifen can be given to post or premenopausal women but Femara would only be prescribed to women that are postmenopausal. The reason being, is that a premenopausal women will still have estrogen produced by the ovaries. Femara would not be effective in this instance.

A Phase III clinical trial that is ongoing shows preliminary results that Femara is superior than Tamoxifen in women with early stage disease that are postmenopausal. The results of the study were published in the Annals of Oncology.

Ovarian cancer clinical trial to test the drug Phenoxodiol was a post I did back in November of 2006.

Its back in the news again saying that so far the studies have shown Phenoxodiol to have an excellent safety profile, with few patients experiencing side effects.

New studies are also being done to help explain the mechanism by which Phenoxodiol induces cancer cell death. This drug interacts with a tumor specific protein and blocks cancerous cells from dividing, causing it to die.

Phenoxodiol also has showed some promise of restoring drug sensitivity in patients that have become resistant to treatment. The OVATURE trial that was discussed in my November post should have results out within 18 months.

Chemotherapy given before surgery to remove cancer is called neoadjuvant treatment. An oncologist might recommend this based of the size of the tumor -- it being very large. The idea is to shrink the tumor and then have surgery to remove the cancer.

Having chemotherapy administered while the tumor is still there can show what drugs are working and what drugs have no effect on the tumor. Chemotherapy when started immediately, not after surgery with healing time needed, gives the patient systematic treatment right away. This could be beneficial and is why physicians might recommend this form of treatment. The truth is they don't know if it is better or not.

Of course, every case of breast cancer is different. We all need to make tough decisions regarding our treatment plan. The facts are that currently there is no evidence that survival is improved with neoadjuvant verses adjuvant (after surgery) chemotherapy in women with locally advanced breast cancer.

The clinical trials that are done help physicians understand what treatments are more effective. Results from a Phase II clinical trial was published in the Journal of Clinical Oncology. It stated that neoadjuvant treatment with Taxotere, Navelbine, and Herceptin resulted in a complete disappearance of detectable cancer in 39 percent of women with locally advanced HER2 positive breast cancer.

The study showed that after two years followup, on the thirty one women with locally advanced breast cancer involved in the study, the overall survival was 97 percent and cancer free survival was 84 percent.

So, the message here is that, even though the study group was small, the results showed a good response to this treatment plan.

Breast cancer drug Herceptin has been approved in Europe for use with hormonal therapy for postmenopausal patients with HER2 and hormone receptor positive metastatic disease.

Herceptin, made by Swiss drugmaker Roche Holding AG, is already approved in Europe for early and metastatic HER2-positive breast cancer.

This new approval is based on data from an international late stage clinical trial showing the combination of Herceptin with hormonal therapy doubled the median progression-free survival time.

Cancer is a scary word -- pancreatic cancer is beyond scary. It has one of the highest mortality rates of all cancers. Symptoms of the disease usually are hard to recognize and most patients are diagnosed in the advanced stages.

Anytime I read about a new drug that can increase the survival of this deadly disease I get excited. An early online publication of the Journal of Clinical Oncology states that the addition to the targeted agent Tarceva (erlotinib) to Gemzar (gemcitabine) can improve survival in patients diagnosed with advanced pancreatic cancer.

The Phase III clinical trial included 569 patients who were either treated with Tarceva plus Gemzar or Gemzar plus placebo. At one year the survival of those treated with the drug combination reached 23 percent. Gemzar alone had a 17 percent survival rate at one year. The study also said that more patients treated with the combination of Tarceva/Gemzar achieved stabilization of their disease.

I am hoping that sooner, rather than later this disease will not be beyond scary and will be something that can be treated, controlled and one day cured.

A half a million volunteers are being sought out by the American Cancer Society (ACS) that are willing to let researchers watch them for twenty years to see if they develop cancer.

Cancer is the second leading cause of death in the United States. The idea behind this large study is to compare it to other big studies in Europe and Asia, who are searching for environmental and lifestyle factors that cause cancer.

The group will recruit men and women between the ages of 30 and 65 who have never been diagnosed with cancer. The volunteers will give blood to be tested and answer questionnaires at various times over the next twenty years.

Eugenia Calle, managing director of analytic epidemiology at the American Cancer Society, said in a statement "This type of study involves hundreds of thousands of people, with diverse backgrounds, followed for many years, with collection of biological specimens and assessments of dietary, lifestyle and environmental exposures".

Cancer drug Gleevec, used for the treatment of chronic myeloid leukemia (CML), has been pulled out of another round of testing so it can get to work stopping the return of a rare stomach cancer. It's that good, according to findings announced on Thursday.

The promise of Gleevec should make it standard treatment for people with gastrointestinal stromal tumors (GIST), a stomach and intestine cancer diagnosed in 5,000 to 6,000 Americans each year.

The drug has already been used for patients whose disease is too advanced for surgery. Now it will be used for those whose tumors can be removed. The drug will be administered for at least one year post-surgery.

More than 600 people participated in this Gleevec trial. Each person took either Gleevec or a sugar pill for one year after surgery. After the one-year mark, cancer returned in 17 percent of people taking the sugar pill and in 3 percent of people taking the actual drug.

Since 50 to 90 percent of GIST cases recur over time, this is great news, say researchers who call Gleevec a highly targeted cancer drug with few side effects.

Today I offer you not so much a Thought for the Day but a Question for the Day. Before I ask my pressing question, though, I want you to consider this story.

Diagnosed with a rare malignant melanoma on her retina in 2001, Ann Guthrie, a South Carolina wife and mother of two grown sons, endured radiation and chemotherapy. The treatments shrunk Guthrie's tumor, but another mass appeared two years later, forcing the removal of her right eye.

At about the same time Guthrie lost her eye, cancer was discovered in her lungs. It was inoperable. Then cancer landed in her brain. And now, without any approved treatment avenues, Guthrie is out of options.

Like many people with terminal illnesses, this woman is willing to try just about anything -- a clinical trial, experimental drugs, risky treatments -- to extend her life. If she's going to die anyway, why not? She just might live longer. And if she doesn't, she could at least help advance science by offering herself up as a sort of guinea pig.

While the Food and Drug Administration (FDA) has proposed changes that would make it easier for patients to access options like these, it's just not that simple right now.

There are ethical issues -- like weighing the needs of people who think anything is better than death against the need of society to prove drugs and treatments work safely. The only way to ensure a sort of balance is through clinical trials -- and letting anyone participate in clinical trials, for example, would make the results harder to interpret.

And there are medical and legal risks. What if terminally ill patients end up in worse shape after a treatment with an experimental drug, for example? What if the FDA or a physician is considered responsible for adverse drug reactions?

Denying terminal patients their last bits of hope is difficult. "It's a hard discussion to have with a patient and his family," says one doctor. "There's a lot of tears. We all would love to be able to get them access to some form of therapy."

And now for my question:

What do you think about terminally ill cancer patients and their access to anything that might extend -- or save -- their lives?

Sanofi-Aventis, one of the world's leading pharmaceutical companies, issued a press release that stated Taxotere (docetaxel) improves survival in patients with metastatic prostate cancer.

A Phase III clinical trial named TAX 327 compared Taxotere plus prednisone to Novantrone (mitoxantrone) plus prednisone. The study included a little over a thousand men who had recurrences or spread of disease after hormonal therapy.

The results of the study showed that survival was improved by 21 percent among patients treated with the Taxotere based therapy. The men also were without pain for a longer periods of time than those treated with Novantrone based therapy.

Researchers conclude that these long term results continue to provide evidence that Taxotere based therapy improves survival for advanced prostate cancer patients.