Clinical breast cancer
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Clinical breast cancer · Apr 2010
ReviewIntegrating bevacizumab into the treatment of patients with early-stage breast cancer: focus on cardiac safety.
Significant advances have been made in the treatment of patients with breast cancer in recent years. As increasing numbers of patients become long-term survivors, there must be a greater focus on treatment-induced chronic toxicities, such as left ventricular dysfunction, congestive heart failure (CHF), and/or secondary treatment malignancies. More recently, the HER2-targeted monoclonal antibody (MoAb) trastuzumab has been found to increase the risk for CHF, particularly when used in combination with an anthracycline or in anthracycline-pretreated patients. ⋯ Cardiac toxicity has been reported in association with bevacizumab-based therapy in patients with advanced or metastatic breast cancer, many of whom were previously exposed to anthracyclines. Although there is currently little evidence to suggest that bevacizumab increases the risk or worsens the severity of cardiac events in these patients, it is anticipated that ongoing, well-designed prospective trials will fully evaluate the cardiac safety of bevacizumab in patients with early-stage breast cancer. This review analyzes the cardiac safety profile of bevacizumab in breast cancer, with a focus on early-stage disease, and the ongoing clinical development of this important new drug.
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Clinical breast cancer · Apr 2010
Oncologists' recommendations for adjuvant therapy in hormone receptor-positive breast cancer patients of varying age and health status.
Currently, evidence supports the use of adjuvant endocrine therapy with aromatase inhibitors in post-menopausal patients with hormone receptor (HR)-positive breast cancer. The goal of the current study is to understand the effect of patient age and health status on oncologists' decision to recommend adjuvant treatment (endocrine therapy and chemotherapy) in older women with HR-positive breast cancer. ⋯ With increasing age and declining health status, oncologists were more likely to recommend endocrine therapy alone as opposed to chemotherapy with endocrine therapy. Oncologists were most likely to recommend aromatase inhibitors, irrespective of age or health status.