Interview
with Neil Love, MD Breast Cancer Update for Medical Oncologists,
Program 6 2000
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Audio Below:
Initially,
we were a little bit concerned by the fact that it required a monthly
IM injection. In fact, in the trial it was not a problem, and most
people, I think, would say that very few patients declined participation
simply because they were going to get an IM injection. These are
patients with metastatic breast cancer. If they think that there
might be a better therapy or something that could work – I
mean, after all, we give them high dose chemotherapy and bone marrow
transplantation. A monthly IM injection is a pretty modest annoyance,
particularly since it doesn’t cause very much, if any, real
side effects.
The
nurses were upset, initially, because they are routinely taught
that you don’t give more than a couple of cc’s intramuscularly,
and here, in England, they were giving 5 cc’s in one injection.
And once the nurses got trained in the UK, it wasn’t a problem.
We thought it was going to be a problem in the States, and that’s
why we decided to give bilateral injections of 2.5 cc’s in
each dose. I think, from what I know now, if I had a patient, I’d
give all of it in one dose in one buttock. That seems easier and
it doesn’t seem to be any more toxic or have any more side
effects. And if you think about it, would you rather have a little
bit of soreness in one buttock or would you rather have a little
bit in the other? In fact, most patients have none, so it’s
really a non-issue. I think it just requires education of the nurses
and physicians that giving a big dose is okay in this situation.
So,
in the end, I think for metastatic disease it’s not an issue.
Maybe it will be a little bit more of a problem when you go to healthier
and healthier patients, but I think if they knew that they had a
drug that was more effective, and now I’m assuming. Let’s
just take the possibility that in the adjuvant setting, it’s
a little more effective – I don’t think you’d have
any trouble convincing a cancer patient who has a life-threatening
disease from coming over and have a nurse giving her an IM injection
once a month.
Similarities
and distinctions in the mode of action of different classes of antioestrogens
[Review]. Wakeling,
A. E. Endocrine-Related Cancer. 7(1):17-28, 2000 Mar. No abstract
Approaches
targeted to estrogen receptors for treatment of tamoxifen-resistant
breast cancer: A brief overview. Terakawa, N. (Reprint available from: Terakawa N Tottori Univ,
Sch Med, Dept Obstet & Gynecol Yonago Tottori 683 Japan)..
Oncology. 59(Suppl 1):3-4, 2000. No abstract
Treatment
with the pure antiestrogen faslodex (ICI 182780) induces tumor necrosis
factor receptor 1 (TNFR1) expression in MCF-7 breast cancer cells. Smolnikar,
K.; Loffek, S.; Schulz, T.; Michna, H., and Diel, P. (Reprint available
from: Smolnikar K DSHS Cologne, Inst Morphol & Tumor Res Carl
Diem Weg 6 D-50927 Cologne Germany). Breast Cancer Research &
Treatment. 63(3):249-259, 2000 Oct. In process
Symposium
overview: Estrogens and antiestrogens in managing the patient with
breast cancer. Newman,
L. A.; Wood, W. C.; Sellin, R. V.; Morrow, M.; Vogel, C., and Singletary,
S. E (Reprint available from: Singletary SE Univ Texas, MD Anderson
Canc Ctr, Dept Surg Oncol 1515 Holcombe Blvd,Box 106 Houston, TX
77030 USA).. Annals of Surgical Oncology. 7(8):568-574, 2000 Sep.
In process
