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duminică, 5 august 2012

Awareness, Detection And Treatment Programs Required To Improve Breast Health Care In Pakistan

Among most women in Pakistan, there is limited awareness of breast cancer occurrence, detection, and screening practices, or the importance of self-breast exams and clinical breast exams, according to a study in the August issue of the Journal of the American College of Radiology. In Pakistan, breast cancer is the most common cancer affecting women and the incidence is rising. It is usually diagnosed in later stages and often at a younger age compared with populations in the West.

"Breast cancer care in limited-resource countries generally suffers because of multiple obstacles, including a lack of recognition of breast health as a public health priority, a shortage of trained health care workers and social or cultural barriers. An improved understanding of existing obstacles in breast cancer care is critical to identify those factors that may be correctable and thereby devise effective interventions for improving early breast cancer detection and treatment in disadvantaged countries," said Sughra Raza, MD, co-author of the study.

Questionnaires were developed to address demographics, financial and educational levels, knowledge regarding breast cancer occurrence and treatment, and religious and cultural beliefs that may affect seeking care for breast disease. Using the questionnaires, one-on-one surveys were administered by community health workers in Karachi to 200 women and 100 general practitioners.

Survey results showed that women's knowledge of breast cancer incidence, diagnosis and treatment was proportionate to educational level, while willingness to address breast health issues and interest in early detection were high regardless of education level. Very few women had ever undergone clinical breast examinations or mammography. Among general practitioners, most understood major risk factors and importance of early detection. However, 20 percent did not believe breast cancer occurs in Pakistan, and 30 percent believed that it is a fatal disease. Female general practitioners were more likely to perform clinical breast examinations than male general practitioners.

"Although there is limited awareness regarding breast cancer occurrence, detection, and screening practices, as well as the importance of self-breast exams and clinical breast exams, the majority of women are very keen to learn more, to participate in their own care and to lower their risk," said Raza.

"Awareness and educational activities, including training female clinical health workers to perform clinical breast exams, will be beneficial, as we begin instituting awareness, detection and treatment programs in the face of a rapidly rising incidence and late-stage detection of breast cancer in Pakistan," said Raza.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Seizures In Babies: Cutting-Edge Imaging Technique To Improve Diagnosis

A cutting-edge technique, combining brain imaging and monitoring of its electrical activity, could improve early diagnosis and treatment of babies who suffer seizures.

Researchers at The Rosie Hospital, Cambridge, are investigating the new technique with funding from children's charity Action Medical Research.

In the UK over 2,000 newborn babies suffer seizures each year.1 Early diagnosis and treatment is vital, as seizures may cause lasting brain damage. However, seizures sometimes go unnoticed, as babies can have no obvious symptoms.

Dr Topun Austin at The Rosie Hospital was awarded £131,150 by Action Medical Research for the two year project. "Seizures remain a major challenge when caring for newborn babies," explains Dr Austin, "but can be difficult to diagnose as abnormal movements of the baby may be subtle or not even present."

Around two or three babies in every 1,000 born alive also suffer from seizures within a month of birth.2,3 Babies born very prematurely are especially vulnerable, as are babies who suffer from a lack of oxygen during birth.

Babies who are suspected of suffering from seizures are normally referred for specialist tests. "The current diagnostic test is an electroencephalogram (EEG), which measures electrical activity within the brain," explains Dr Austin. "EEG has limitations though, as it can only detect seizures occurring near the surface of the brain. It cannot detect abnormalities deeper within the brain."

Dr Austin is developing a new way to diagnose seizures, which combines existing EEG technology with a new optical imaging system. The technique could also help other people with seizures or epilepsy.

"When babies have a seizure, there is a large amount of electrical activity in the brain, which we are measuring with EEG," explains Dr Austin. "The amount of oxygen in the brain also changes, which we are measuring with the new optical system. This system works by shining near-infrared light into the brain, which is harmless and non-invasive."

Dr Austin hopes the new combined technique will boost understanding of what's happening inside the brain during seizures: "The ultimate aim is to develop the new system for routine use at the cot-side."

This project brings together a team of clinicians and scientists with a proven track record in developing new technologies to study the infant brain. Most of the work is being carried out in a new neonatal unit - one of the largest in the country - at the Rosie Maternity Hospital, Cambridge.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our pediatrics / children's health section for the latest news on this subject. 1. Rennie JM, Hagmann CF, Robertson NJ. Neonatal cerebral investigation. (2008) Cambridge University Press.

2. Panayiotopoulos CP. Chapter 5. Neonatal seizures and neonatal syndromes. The Epilepsies: Seizures, Syndromes and Management. Bladon Medical Publishing (Oxfordshire UK) 2005.

3. Davis AS et al. Seizures in extremely low birth weight infants are associated with adverse outcome. J Pediatr 2010; 157: 720-5.

Source: Action Medical Research

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marți, 13 decembrie 2011

Lower Back Pain - MRI Does Not Improve Outcomes For Epidural Steroid Injection Candidates

Editor's Choice
Academic Journal
Main Category: Back Pain
Also Included In: Pain / Anesthetics; MRI / PET / Ultrasound
Article Date: 13 Dec 2011 - 9:00 PST

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According to an investigation published Online First by the Archives of Internal Medicine, one of the JAMA/Archives journals, magnetic resonance imaging (MRI) prior to administration of epidural steroid injections (ESI), does not seem to improve outcomes for individuals with chronic lower back pain or for those with conditions like sciatica, and only has a small effect on the physician's decision making.

In the report the researchers explain:

"Lower back pain is the number one cause of disability in the world, and one of the top three reasons people seek medical attention.
Despite several studies demonstrating that advanced radiologic testing does not improve outcomes in patients with lower back pain, with or without radicular symptoms [nerve irritation, characterized, for example, by pain radiating down the back of the leg], the use of MRI in this context continues to soar.
The lack of unequivocal guidelines on the use of MRI before ESI is somewhat unexpected, considering that ESI is the most frequently performed procedure in pain clinics throughout the United States."

A multi-center randomized study was conducted by Steven P. Cohen, M.D., from Johns Hopkins School of Medicine, Baltimore and his team. A total of 132 patients, primarily women (57%) with an average age of 52, were enrolled to participate in the study.

The researchers randomly assigned participants to two groups. In one group the treating physician was blinded to the MRI results, while for group two the physician decided on treatment after reviewing the MRI findings.

For participants in group one, an independent doctor reviewed the MRI findings and recommended a treatment plan, the plan was then compared to the treatment the participant actually received. All participants in group one received ESIs. In group two not all participants received ESIs, if the MRI finding did not support the treatment, at which point the participant discontinued with the investigation. 34% of all participants were taking opioids. Pre-procedure leg pain scores and function showed moderate to severe dysfunction.

The researchers state:

"Slightly lower leg pain scores were noted in group two at one month compared with MRI-blinded patients in group 1. No differences were observed in pain scores or function at three months.
Overall, the proportion of patients who experienced a positive outcome was similar at all time points (35.4 percent at three months in group one vs. 40.7 percent in group two.
For the patients in group one who received a different injection that was proposed by the independent physician, scores for both leg pain (4.8 vs. 2.4) and function (38.7 vs. 28.2) were inferior to patients whose injection correlated with imaging.
Collectively, 6.8 percent of patients did not (group two) or would not have (group one) received an ESI after the MRI was reviewed."

The team conclude:

"In conclusion, our results suggest that although MRI may have a minor effect on decision making, it is unlikely to avert a procedure, diminish complications, or improve outcomes. Considering how frequently ESIs are performed, not routinely ordering an MRI before a lumbosacral ESI may save significant time and resources."

In a commentary associated with the report, Janna Friedly, M.D., from the University of Washington, Seattle, and Richard A. Deyo, M.D., M.P.H., from Oregon Health and Science University, Portland, Ore., explain:

"Given the modest benefits of epidural injections themselves, it may not be surprising that the benefit of imaging prior to injection is hard to demonstrate.
Although the overall results of this study were largely negative, they suggest a small benefit to using MRI to guide epidural steroid injection planning in patients with lumbar radiculopathy. Use of MRI may have reduced the total number of injections required and may have improved outcomes in a subset of patients.
Given these potential benefits as well as concerns related to missing important rare contraindications to epidural steroid injection, it seems premature to counsel against guideline recommendations for obtaining MRI prior to consideration of epidural steroid injections.
In the meantime, cost savings and clinical benefit might result from discouraging epidural injections in conditions for which efficacy is unclear, such as spinal stenosis and low back pain without radiculopathy. More prudent patient selection may help offset the costs of obtaining advanced imaging prior to injection for those in whom a treatment benefit is more likely."

Written by Grace Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our back pain section for the latest news on this subject. Arch Intern Med. Published Online December 12, 2011. doi:10.1001/archinternmed.2011.593. & doi:10.1001/archinternmed.2011.581. Please use one of the following formats to cite this article in your essay, paper or report:

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duminică, 11 decembrie 2011

To Keep Nurses, Improve Their Work Environments

Main Category: Nursing / Midwifery
Article Date: 10 Dec 2011 - 0:00 PST

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Nurses working in hospitals around the world are reporting they are burned out and dissatisfied with their jobs, reported researchers at the University of Pennsylvania School of Nursing's Center for Health Outcomes and Policy Research in a study of 100,000 nurses in nine countries.

Between 20 to 60 percent of nurses reported symptoms of burnout according to the study, published in the International Journal for Quality in Health Care, which collected data from nurses in more than 1,400 hospitals to determine the effect of hospital work environments on hospital outcomes.

"The percentage of nurses reporting high burnout was over a third in most countries and decidedly higher in South Korea and Japan, near 60 percent in both countries," said lead author Linda Aiken, PhD, RN, director of the Center of Health Outcomes and Policy Research at Penn Nursing. " Job dissatisfaction varied from 17 percent in Germany to around a third of nurses in most countries and a high of 60 percent dissatisfied in Japan. Almost half of nurses in all countries, except in Germany, and many more than half of the nurses in a few of the countries, lacked confidence that patients could manage their care after discharge," said Dr. Aiken.

Hospitals with better work environments had lower burnout, lower likelihood of job dissatisfaction and a decrease in reports of little or no confidence in discharge readiness of patients. In hospitals with poor work environments the percentage of nurses who believed patients were not prepared for discharge ranged between 22 percent and 85 percent.

"How well nurses are faring in their jobs has been found to be a barometer of how well patients in those same hospitals are faring," said Dr. Aiken. " In all countries, more than one in ten nurses report that care is either fair or poor, and in three of four Asian countries studied, nurses' ratings of fair/poor care are much more frequent."

The nine countries that participated in the study were: China, South Korea, Thailand, Japan, New Zealand, Canada, Germany, the United Kingdom, and the United States.

Dr. Aiken and her colleagues point to hospital leaders and policy makers to improve the nurse workforce and quality of care by increasing staff, improving nurse and physician relations, involving nurses more in hospital decisions, and greater managerial support of those who provide clinical care at the bedside.

"Increased attention to improving work environments might be associated with substantial gains in stabilizing the global nurse workforce while also improving quality of hospital care throughout the world," said Dr. Aiken.

Using measurements developed by Dr. Aiken and colleagues, researchers tracked nurses' responses to questions about staffing-resource adequacy, nurse manager ability and leadership, nurse-physician relations, nurse participation in hospital affairs, and nursing foundations for quality of care.

This study was supported by the National Institute of Nursing Research, National Institutes of Health, the University of Pennsylvania School of Nursing Office of Global Affairs, the China Medical Board, the National Research Foundation of Korea, the University of Auckland's staff fund, Rho Pi Chapter, Thailand, Sigma Theta Tau International, Nurses' Association of Thailand, the International Research Grant by Pfizer Health Research Foundation.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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vineri, 9 decembrie 2011

To Keep Nurses, Improve Their Work Environments

Main Category: Nursing / Midwifery
Article Date: 09 Dec 2011 - 2:00 PST

"The percentage of nurses reporting high burnout was over a third in most countries and decidedly higher in South Korea and Japan, near 60 percent in both countries," said lead authors Linda Aiken, PhD, RN, director of the Center for Health Outcomes and Policy Research at Penn Nursing. "Job dissatisfaction varied from 17 percent in Germany to around a third of nurses in most countries and a high of 60 percent dissatisfied in Japan. Almost half of nurses in all countries, except in Germany, and many more than half of the nurses in a few of the countries, lacked confidence that patients could manage their care after discharge," said Dr. Aiken.

Hospitals with better work environments had lower burnout, lower likelihood of job dissatisfaction and a decrease in reports of little or no confidence of discharge readiness of patients. In hospitals with poor work environments the percentage of nurses who believed patients were not prepared for discharge ranged between 22 percent and 85 percent.

"How well nurses are faring in their jobs has been found to be a barometer of how well patients in those same hospitals are faring," said Dr. Aiken. "In all countries, more than one in ten nurses report that care is either fair or poor, and in three of four Asian countries studied, nurses' ratings of fair/poor care are much more frequent."

The nine countries that participated in the study were: China, South Korea, Thailand, Japan, New Zealand, Canada, Germany, the United Kingdom, and the United States.

Article adapted by Medical News Today from original press release. Source: University of Pennsylvania School of Nursing
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Animal Study Offers Insights Into Possible Drug Targets To Improve Memory As We Age

Main Category: Neurology / Neuroscience
Also Included In: Seniors / Aging; Alzheimer's / Dementia
Article Date: 09 Dec 2011 - 2:00 PST

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Drugs that affect the levels of an important brain protein involved in learning and memory reverse cellular changes in the brain seen during aging, according to an animal study in The Journal of Neuroscience. The findings could one day aid in the development of new drugs that enhance cognitive function in older adults.

Aging-related memory loss is associated with the gradual deterioration of the structure and function of synapses (the connections between brain cells) in brain regions critical to learning and memory, such as the hippocampus. Recent studies suggested that histone acetylation, a chemical process that controls whether genes are turned on, affects this process. Specifically, it affects brain cells' ability to alter the strength and structure of their connections for information storage, a process known as synaptic plasticity, which is a cellular signature of memory.

In the current study, Cui-Wei Xie, PhD, of the University of California, Los Angeles, and colleagues found that compared with younger rats, hippocampi from older rats have less brain-derived neurotrophic factor (BDNF) - a protein that promotes synaptic plasticity - and less histone acetylation of the Bdnf gene. By treating the hippocampal tissue from older animals with a drug that increased histone acetylation, they were able to restore BDNF production and synaptic plasticity to levels found in younger animals.

"These findings shed light on why synapses become less efficient and more vulnerable to impairment during aging," said Xie, who led the study. "Such knowledge could help develop new drugs for cognitive aging and aging-related neurodegenerative diseases, such as Alzheimer's disease," she added.

The researchers also found that treating the hippocampal tissue from older animals with a different drug that activates a BDNF receptor also reversed the synaptic plasticity deficit in the older rats. Because histone acetylation is important in many functions throughout the body, these findings offer a potential pathway to treat aging-related synaptic plasticity deficits without interfering with histone acetylation.

"It appears that lifelong shifts in gene regulation steadily deprive the brain of a key growth factor and cause a collapse of the 'machinery' supporting memory, cognition, and the viability of neurons," said Gary Lynch, PhD, a synaptic plasticity expert at the University of California, Irvine. "The very good news suggested by this study is that it may be possible to reverse these effects."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our neurology / neuroscience section for the latest news on this subject. The research was supported by the National Institute on Aging and UCLA Older Americans Independence Center.
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Unique Genetic Marker May Improve Detection Of Recurrent Ovarian Cancer

Main Category: Ovarian Cancer
Article Date: 09 Dec 2011 - 1:00 PST

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Ovarian cancer is a major health concern for women and the identification of sensitive biomarkers for early detection and/or monitoring of disease recurrence is of high clinical relevance.

New work published in the online journal PLoS ONE reports promising advances toward the development of blood-based DNA markers for ovarian cancer.

The researchers, led by Peter W. Laird of the University of Southern California in Los Angeles, found that a DNA modification called "methylation" at a specific DNA site occurs frequently in ovarian tumors and can also be detected in the blood of ovarian cancer patients. This newly described methylation site was identified through a rigorous high-throughput screening process that tested over 27,000 different sites in the genome.

The epigenetic marker identified in this study was shown to have the potential to monitor disease status after surgery and might therefore prove helpful in enhancing the performance of existing biomarkers for disease recurrence.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our ovarian cancer section for the latest news on this subject. Citation: Campan M, Moffitt M, Houshdaran S, Shen H, Widschwendter M, et al. (2011) Genome-Scale Screen for DNA Methylation-Based Detection Markers for Ovarian Cancer. PLoS ONE 6(12): e28141. doi:10.1371/journal.pone.0028141
Financial Disclosure: This work was supported by the Ovarian Cancer Research Fund, grant PPD/USC.06, and National Institutes of Health and National Cancer Institute, grant R01-CA096958. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interest Statement: PL is a consultant and Scientific Advisory Board member for Epigenomics AG. He holds issued patents on the MethyLight technology, which have been licensed to Epigenomics AG. This work was not supported by Epigenomics AG. Epigenomics had no role in study design, data collection or analysis, decision to publish, or preparation of the manuscript. In addition, PL and MC are named as inventors on a pending patent application for the Digital MethyLight technology. The patents and the relationship with Epigenomics do not alter the authors' adherence to all the PLoS ONE policies on sharing data and materials. The other authors disclosed no potential competing interest.
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joi, 8 decembrie 2011

New Protocols Improve Detection Of MicroRNAs For Diagnosis

Main Category: Medical Devices / Diagnostics
Also Included In: Pregnancy / Obstetrics; Breast Cancer
Article Date: 08 Dec 2011 - 2:00 PST

MicroRNAs (miRNAs) that regulate processes including fertilization, development, and aging show promise as biomarkers of disease. They can be collected from routinely collected fluids such as blood, saliva, and urine. However, a number of factors can interfere with the accuracy of miRNA tests. In a study published online today in the Journal of Molecular Diagnostics, a group of researchers provide clear procedures for the collection and analysis of miRNA, significantly improving their diagnostic accuracy.

"Our study demonstrates that inherent differences in biological samples and the methods used to collect and analyze them can dramatically affect the detection and quantitation of microRNAs," reports lead investigator Dominik M. Duelli, PhD, Department of Cellular and Molecular Pharmacology, Chicago Medical School at Rosalind Franklin University of Medicine and Science. "We developed measures to overcome the interfering activities and improved the sensitivity of miRNA detection up to 30-fold."

Over 1,000 miRNAs exist in the human body. Deregulation of specific miRNAs is associated with disease. Measuring the amount of miRNAs in body fluids can aid in the diagnosis of disease or conditions such as pregnancy. Dr. Duelli and his colleagues quantified two miRNAs: miR-16, which acts as a tumor suppressor and is deregulated or lost in some cancers, including breast cancer; and miR-223, which has been implicated in pregnancy and other conditions, as well as in some malignant diseases.

"A fundamental challenge to making microRNA diagnostics broadly available has been the inability to isolate enough high quality material to analyze. Our paper outlines ways of effectively collecting blood plasma samples, thus bringing us one step closer to the goal of making [miRNA] disease diagnostics a reality," adds co-investigator Sarah Linnstaedt, PhD, of Duke University.

The authors found that the choice of blood collection tube affects quantitation. Traditional green-top heparin tubes interfered nearly completely with miRNA detection. Grey-top tubes containing the anticoagulant sodium fluoride and potassium oxalate (NaF/KOx) provided the best results. Although miR-16 is about 500 times more abundant in blood plasma than miR-223, the results for both were similar, indicating that the differences in detection resulting from the choice of collection method apply to other miRNAs. Furthermore, collection of miR-223 in serum yielded more variable results, signifying that for some miRNAs, analysis of blood in plasma form is preferred.

The study indicated that natural components of blood plasma co-purify with miRNAs, interfering with their detection. The authors identified extra steps in purification, and the ideal dilution level, to reduce the interference. "Although counterintuitive, by reducing the starting material, inhibitors were presumed to be diluted below a threshold of interference. Careful titration of starting material yields more accurate miRNA quantitation," explains Dr. Duelli. In another approach, the authors avoided the problem of contamination by combining an enzyme that overcomes plasma inhibitors with standard enzymes to increase the sensitivity of miRNA detection by about 30-fold.

Finally, the authors observed that differences in plasma composition among individual donors yield different miRNA measurements. "These results raise the possibility that factors including diet, exercise, circadian rhythms, and seasons, which alter the blood chemistry, might affect miRNA detection and quantitation," says Dr. Duelli.

"The implications of this work are that without consideration of the variables we have identified, miRNA quantitation of human samples may not be reliable for the purpose of biomarker development. We provide approaches that enable faithful quantitation of miRNA abundance in body fluid," concludes Dr. Duelli.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our medical devices / diagnostics section for the latest news on this subject. The article is "Plasma Components Affect Accuracy of Circulating Cancer-Related MicroRNA Quantitation," by D-J. Kim, S. Linnstaedt, J. Palma, J. Cheol Park, E. Ntrivalas, J.Y.H. Kwak-Kim, A. Gilman-Sachs, K. Beaman, M.L. Hastings, J.N. Martin, and D.M. Duelli (doi: 10.1016/j.jmoldx.2011.09.002). Published online ahead of its issue, the study will appear in the Journal of Molecular Diagnostics, Volume 14, Issue 1 (January 2012) published by Elsevier.
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Natural Supplement Shown To Improve Mental Performance And Decrease Test Anxiety By 17 Percent

Main Category: Nutrition / Diet
Also Included In: Neurology / Neuroscience
Article Date: 08 Dec 2011 - 2:00 PST

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Keeping your brain in shape...no sweat. Health-conscious consumers may not realize that supplementing a healthy diet is just as important to maintaining mental performance as it is to maintaining six-pack abs. Natural supplements are an easy, effective way to manage mental focus, memory and overall mood. Natural supplement Pycnogenol® (pic-noj-en-all), an antioxidant plant extract from the bark of the French maritime pine tree, was found to significantly enhance mental performance in healthy college students in a recent clinical trial published in Panminerva Medica.

The study was conducted at Pescara University and examined 53 Italian university students, aged 18-27. Students were assigned to a control or test group. The test group was given 100 mg of Pycnogenol® per day, over a period of eight weeks. Students' mental performance was evaluated using cognitive function tests that were carried out by computer-assisted methods. Students' final exam scores were also evaluated. Verbal IQ tests ensured that students recruited for the study demonstrated highly comparable intelligence.

The study found that: Pycnogenol® effectively enhanced mental performance, including improved sustained attention, memory and mood in students within an eight week period Students taking Pycnogenol® had higher test scores on university exams than the control group Alertness and contentedness improved significantly within the Pycnogenol® group and levels of anxiety decreased by 17 percent "Oxygen-rich blood supply to the brain plays an important role for cognitive function and the improvement of vascular function with Pycnogenol® may be responsible for the beneficial effects found in this study," says Dr. Gianni Belcaro, the lead researcher from Pescara University, Italy.

Results showed that not only did Pycnogenol® decrease test anxiety, but also confirmed Pycnogenol®'s ability to improve mental performance by evaluating students' scores on exams. Researchers suggest that several physiologic contributions of Pycnogenol® may have contributed to the improved cognitive function of investigated students, namely antioxidant potency and blood circulation improvement. While the results are promising they need to be further investigated in a larger population group.

This study confirms previous findings that Pycnogenol® effectively improves cognitive function. Research published in the Journal of Psychopharmacology demonstrated that Pycnogenol® supplementation improved both numerical working memory as well as spatial working memory in Australian senior citizens.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our nutrition / diet section for the latest news on this subject. Pycnogenol® is a natural plant extract originating from the bark of the maritime pine that grows along the coast of southwest France and is found to contain a unique combination of procyanidins, bioflavonoids and organic acids, which offer extensive natural health benefits. The extract has been widely studied for the past 40 years and has more than 280 published studies and review articles ensuring safety and efficacy as an ingredient. Today, Pycnogenol® is available in more than 700 dietary supplements, multi-vitamins and health products worldwide. For more information, visit http://www.pycnogenol.com./
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Oral Bisphosphonate Did Not Improve Prognosis For Patients With Breast Cancer

Main Category: Breast Cancer
Article Date: 08 Dec 2011 - 3:00 PST

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Results from a German study demonstrated no improvement in disease-free survival among patients with breast cancer who were treated with dose-dense chemotherapy and the bisphosphonate ibandronate.

Volker Möbus, Ph.D., head of the department of obstetrics and gynecology at Klinikum Frankfurt Höchst GmbH in Frankfurt, presented the results from the German Adjuvant Intergroup Node Positive (GAIN) Study, at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, held Dec. 6-10, 2011.

Möbus and his colleagues randomly assigned 3,023 patients with breast cancer to two different chemotherapy regimens and then further assigned them to 50 milligrams of oral ibandronate or observation. After a median follow-up of 38.7 months, "we found no significant difference between groups in the primary endpoint" of disease-free survival, Möbus said.

He described these results as "disappointing" compared with other studies. In the Adjuvant Treatment with Zoledronic Acid in Stage II/III Breast Cancer (AZURE) trial, for example, Möbus said that the subgroup of postmenopausal patients showed an improvement in recurrence-free and overall survival.

"So far, clinical trials of adjuvant bisphosphonates in early breast cancer have shown variable results, independent from their application (oral compared with intravenous)," Möbus said.

More recently, two trials the Austrian Breast & Colorectal Study Group (ABCSG-12) and the Zometa-Femara Adjuvant Synergy Trial (ZO-FAST) have shown significant benefit in patients with hormone receptor-positive breast cancer who were postmenopausal and received an endocrine treatment only.

Möbus said that in the AZURE trial, 95 percent of patients received chemotherapy and only postmenopausal patients showed an improvement in the zoledronic acid group. "In our [GAIN] trial, all patients received dose-dense chemotherapy, and unfortunately, we could not show a benefit in any subgroup," he said. "We speculate that the high efficacy of dose-dense chemotherapy erases the potential effect of bisphosphonates, which is shown in patients with endocrine treatment only."

Article adapted by Medical News Today from original press release. Source: American Association for Cancer Research
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