*BIG 1-98 showed that LETROZOLE was more effective in post-menopausal patient with any histology of breast cancer that is ER positive and Her-2 Negative, with the effect being greater in lobular type of Carcinoma. And in Luminal B versus Luminal A.
* In HER-2 positive, one year Vs 2 Years.
"2 year long treatment not recommended",
finding of the HERA trial remains the standard of care.
In the study of 6 months Vs 12 months of Herceptin, there was a trend toward better results with 12 months also statistically no difference was detected.
*In Early Breast cancer, High Baseline of Vitamin D level was a predictor of 3 things:
1. better prognosis
2. low risk bone relapse
3. better outcome with use of Zometa.
recommendation is to measure Vit D at diagnosis and to replenish it!
*In triple negative breast cancer, the disease would be amenable to new type combinations of medications such as
A/ Cisplatin /PARP (olaprib) and Vandetanib (EGFR/VEGF).
B/ Cisplatin/PARP inhibitor and Vorinostat (Histone deacetylase inhibitor)
C/ Androgen Inhibitors and MTOR
*PD 0332991, an oral Cyclin dependent Kinase (CDK 4/6) inhibitor added to Letrozole increased the progression free from 7.5 months to 26.1 months. This is an impressive performance if confirmed.
*PIM-1 may be a surrogate of c-MYC amplification, and is being targeted.
* Routine Breast MRI still not recommended
*32mg IV Ondansetron can cause Arrhythmia and has been withdrawn.
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