Highlights from the 2004 American Society of Hematology Meeting

By Jennifer Klem, PhD

New Drugs Pick Up Where Gleevec Leaves Off

Chronic myelogenous leukemia (CML) is a slow-growing but life-threatening disorder of the white blood cells. Gleevec® (imatinib) is a targeted agent that is most effective when patients are in the chronic, or early-stage, phase of the disease. During the accelerated and blast phases (the advanced stages), up to two-thirds of patients don’t go into remission with Gleevec. Even in the chronic phase, 13 percent of patients taking Gleevec become resistant to the drug. Fortunately, new agents are showing promise for these patients.

A new oral compound, BMS-354825, is currently being studied in patients with all stages of Gleevec-resistant CML. At ASH, phase I data, although admittedly too early to be definitive, was extremely promising, with 86 percent of chronic-phase patients with Gleevec-resistant tumors returning to normal white blood cell counts. Even in accelerated and blast phase disease, BMS-354825 produced some benefit in three-fourths of the patients.

AMN107 is another oral drug being developed for application in advanced-stage CML. The report of the phase I trial showed that almost half of the 15 patients tested at the highest dose level benefited from the drug. Based on the performance of these two agents, both will be tested further in phase II trials, giving hope to patients for whom Gleevec is no longer an option.

To learn more about BMS-354825, visit www.bms.com. For more information about AMN107, go to www.novartis.com.

A Promising Drug for Older Leukemia Patients

Zarnestra® (tipifarnib) is an oral medication currently being investigated for acute myelogenous leukemia (AML), the most common type of leukemia in adults, as well as in myelodysplastic syndrome (MDS), a disorder in which abnormal cells crowd out normal cells in the bone marrow.

In a phase II trial of mostly AML patients reported at ASH, Zarnestra treatment was fairly well tolerated and showed a benefit to many of these patients, most of whom were in their 70s. A third of these patients demonstrated a significant decrease in tumor cells after treatment. For more information on clinical trials using Zarnestra, visit www.clinicaltrials.gov.

Highlights from the 2004 San Antonio Breast Cancer Symposium

By Susan Peck, PhD

Advances in Hormonal Therapy

Updated results from the ATAC trial comparing five years of adjuvant hormonal therapy with Nolvadex® (tamoxifen) to the aromatase inhibitor Arimidex® (anastrozole) for women with hormone receptor-positive early breast cancer were presented. After an average follow-up of 68 months, results from 9,366 women demonstrated that compared to tamoxifen, Arimidex reduces the recurrence of breast cancer by 17 percent, although no difference in overall survival has been observed yet. For more information on Arimidex, visit www.arimidex.com.

A second strategy is to switch to an aromatase inhibitor after two to three years of therapy with tamoxifen. An updated analysis of the International Exemestane Study demonstrated a significant advantage in switching to Aromasin® (exemestane) for two to three years following an initial two to three years of tamoxifen. The risk of breast cancer recurrence was reduced by 30 percent for women switched to Aromasin. Reinforcing these findings, combined results from trials by the Austrian Breast and Colorectal Study Group and the German Adjuvant Breast Cancer Group demonstrate that switching to Arimidex for three years following two years of tamoxifen resulted in a 40 percent reduction in breast cancer recurrences. For more on Aromasin, visit www.aromasin.com.

Advances in Chemotherapy

A phase III trial compared the combination of Xeloda® (capecitabine) with either Taxol® (paclitaxel) or Taxotere® (docetaxel) in the treatment of metastatic breast cancer. An interim analyses of 206 patients revealed that 58 percent of patients responded to Xeloda alone, while approximately 75 percent of women responded to the Xeloda/taxane combination. For more information on Xeloda, visit www.xeloda.com.

Preventing Bone Loss in Women with Breast Cancer

Results from a study done by the Austrian Breast Cancer Study Group suggest that Zometa® (zoledronic acid) may be able to protect against bone loss associated with hormonal therapies.

These findings are supported by data from the Z-FAST trial in which postmenopausal women with early-stage breast cancer received Femara® (letrozole) plus Zometa. After six months, women who received Zometa had an increase in the density of their spine of 1.5 percent compared to a 2 percent decrease in those who received Femara alone. For more on Zometa, visit www.zometa.com.

Oncology on Canvas Winners Announced at San Antonio Meeting

Patients, caregivers and healthcare providers were honored for their outstanding artistic expressions of their cancer experience as part of Oncology on Canvas: Expressions of a Women's Cancer Journey, an international art competition, sponsored by Eli Lilly and Company. Lilly honored three American artists for their winning work during a reception and art showing held in conjunction with the San Antonio Breast Cancer Symposium in San Antonio, Texas.  

More than 450 pieces of art from 23 countries, including the United States, United Kingdom, Mexico, Hungary, South Africa, Turkey and India were submitted for consideration.  

Monica Barry, a registered nurse and aspiring artist from Houston, was honored as the "Best of USA" and "Best Submission by a Health Care Professional" for her work "Metamorphosis." Barry's work presents a thoughtful portrayal of a woman with short post-therapeutic hair growth and a pink ribbon over the area where her right breast used to be. As Barry says in the narrative of her work: "Regardless of mastectomy and chemotherapy, she has never lost her beauty and conviction."

Barry said the painting represents women who have battled breast cancer and those who have been affected by the disease, but the true inspiration was her mother-in-law who passed away in 1997 from breast cancer. "She was my best friend and my confidant and mentor," said Barry. "She was the woman that I wanted to be like. I did this painting for her."

Janna Bernheim Bernstein of Memphis, Tennessee, was honored as the second-place U.S. winner for her charcoal work entitled "Healing." Bernheim Bernstein, a Fulbright Scholar and art teacher, and single mother of three girls, was diagnosed with breast cancer at age 49 in August 2000. Her diagnosis came just three weeks after her mother passed away from pancreatic cancer.

"The advances that are made in medicine, such as the ones that Lilly makes, are the reason people are here today," said Bernheim Bernstein. "It was too late for my mother, but these advances are here for me and others."

She said she also found inspiration in birds and wings as they represent her belief of being lifted up, supported and transported above the illness and other earthly endeavors.

Doralee Kimbrough of Garrison, Texas, was honored as the third-place U.S. winner for a watercolor piece "Spiritual Awakening." Kimbrough, a retired second-grade teacher, mother of three, and grandmother of six, was diagnosed with breast cancer in 2001.

Kimbrough's piece is a watercolor of a tree and underground roots. The tree, which symbolizes her body, appears to be void of life until close examination of the tree and roots show otherwise. Kimbrough said, "I entitled the work Spiritual Awakening because that is what I experienced after I was diagnosed. I hope that is what others experience when they look at my painting. I hope they look at the work and get something from it that will help them as they go through their cancer journey."

CALENDAR ITEM: The public is invited to a Feb. 18 forum that opens the Wendy and Emery Reves International Biennial Breast Cancer Symposium. This free event, hosted by UT Southwestern and the Susan G. Komen Breast Cancer Foundation, will be held from 5-6:30 p.m. at the Adam's Mark Hotel, 400 N. Olive St. in Dallas, Texas.

It will include a question-and-answer session with UT Southwestern faculty, who will examine the future of breast-cancer risk, prevention and treatment.

The scientific symposium, which begins Feb. 19, will offer a panel of investigational and clinical experts to share emerging science and technologies in genetics, imaging, surgery, targeted therapies and clinical trials for breast cancer. For more information, call 214-648-3404.