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Switching Adjuvant Breast Cancer Therapy from Tamoxifen to Exemestane Proves Beneficial
A new study has found a strong benefit of an aromatase inhibitor (AI) as adjuvant therapy in postmenopausal breast cancer patients. Published last week in the New England Journal of Medicine, the study found that switching adjuvant therapy after two to three years from tamoxifen to the AI exemestane significantly
improved disease-free survival at approximately two and a half years' follow-up. Conducted under the auspices of the Intergroup Exemestane Study (IES), the results were made available at the recommendation of the study's data and safety monitoring board following the second interim data analysis review.
More than 4,700 patients - all of whom had primary, estrogen-receptor-positive breast cancer - were enrolled in the double-blind, randomized
trial, with slightly less than half assigned to undergo the midstream switch in adjuvant therapy from tamoxifen to exemestane. After a median follow-up of nearly 31 months, there were 266 first events (defined as breast cancer recurrence, contralateral breast cancer, or death) in the tamoxifen group and 183 in the exemestane group, leading to a 32 percent relative reduction in the risk of an event and an overall benefit of disease-free survival of 4.7 percent.
Because these are early release results, the authors explained, it is too soon to expect a statistically significant difference in overall survival. Patients in the exemestane group also had a reduced risk of contralateral breast cancer, endometrial cancer, and other primary cancers.
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Annual Cancer Center Directors' Retreat
On Monday, March 8, National Cancer Institute (NCI) convened a cancer centers directors' retreat in which 59 of 61 NCI-designated cancer centers participated. The purpose of the retreat was to discuss future opportunities
and challenges and the critically important role that the cancer centers play in the National Cancer Program. New technology initiatives and ongoing implementation of the report of the NCAB P30/P50 Ad Hoc Working Group (chaired by Drs. Joe Simone and Art Nienhuis) were central themes. The retreat included the cancer center directors in strategic discussions to facilitate the discovery, development, delivery continuum.
In the late 1960s, 12 cancer centers were NCI-funded. With the enactment of the National Cancer Act in 1971, the Cancer Centers Program formally established and funded 15 additional cancer centers. "The National
Cancer Institute should closely study the use of cancer research centers," the legislation stated, "for it is here that many impressive research findings are being and will be uncovered.
It is also here that the effectiveness of these findings can be proved." In fact, our cancer centers have become extraordinary gravitational forces attracting intellectual capital, financial resources, and programmatic
opportunities.
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This NCI Cancer Bulletin is produced by the National Cancer Institute (NCI). NCI, which was established in 1937, leads a national effort to eliminate the suffering and death due to cancer. Through basic and clinical biomedical research and training, NCI conducts and supports research that will lead to a future in which we can prevent cancer before it starts, identify cancers that do develop at the earliest stage, eliminate cancers through innovative treatment interventions, and biologically control those cancers that we cannot eliminate so they become manageable, chronic diseases.
For more information on cancer, call 1-800-4-CANCER or visit http://www.cancer.gov.
NCI Cancer Bulletin staff can be reached at ncicancerbulletin@mail.nih.gov.
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