This is one of the largest multicentered, cohort studies conducted to evaluate the proinflammatory biomarkers associated with cognitive impairment in breast cancer patients. While elevated interleukin (IL)-6 and IL-1β were observed in patients with poorer response speed performance and perceived cognitive disturbances, IL-4 may be protective against chemotherapy-associated cognitive impairment.

In the 10 years since their initial licensing in Europe, the taxanes, paclitaxel and docetaxel, have emerged as fundamental drugs in the treatment of breast cancer. Clinically meaningful benefits were first shown in the metastatic setting, and large-scale exploration of their roles in the adjuvant therapy of early-stage disease is ongoing. Benefits have been seen in the neoadjuvant setting as well, mainly with docetaxel. This paper reviews the current roles of the taxanes in the treatment of metastatic and early-stage breast cancer. Also addressed are outstanding issues involving optimal dosing and sequencing, as well as a discussion of the relative merits of each agent in this setting. Clinicians should choose a taxane-based regimen for their patients with breast cancer based on consideration of the pharmacokinetics, clinical activity, and dosing schedule that best meets the patients' needs. At the current time, the pharmacokinetic profile, consistent positive clinical results, and convenience of an intermittent, short-infusion schedule have made docetaxel the preferred taxane for many clinicians treating patients with breast cancer. The Oncologist 2004;9(suppl 2): [24][25][26][27][28][29][30][31][32] The Oncologist 2004;9(suppl 2):24-32 www.TheOncologist.com Correspondence: John Crown, M.D., Medical Oncology Research Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. Telephone: 353-1-2094839; Fax: 353-1-2837719; e-mail: john.crown@icorg.ie Received March 11, 2004; accepted for publication March 22, 2004 accepted for publication March 22, . ©1083-7159/2004 INTRODUCTIONThe taxanes have emerged as critically important drugs in the treatment of patients with breast cancer. The relatively accelerated clinical development of these agents can be attributed to the rapid collection of an unprecedented amount of data from numerous large, high-quality prospective random assignment trials, trials that involved literally tens of thousands of patients.

No abstract

This is the first study to demonstrate that patients with either progressive bone metastases or SREs while on clodronate or pamidronate can have relevant palliative benefits with a switch to the more potent bisphosphonate zoledronic acid. This is reflected by significant improvements in pain control and bone turnover markers. If confirmed in randomized trials, these findings have major implications to the use of bisphosphonates in both the metastatic and adjuvant settings.

Background: Renal cell carcinoma patients respond poorly to conventional chemotherapy, this unresponsiveness may be attributable to multidrug resistance (MDR). The mechanisms of MDR in renal cancer are not fully understood and the specific contribution of ABC transporter proteins which have been implicated in the chemoresistance of various cancers has not been fully defined in this disease.

BACKGROUND: Vitamin D deficiency has potential roles in breast cancer etiology and progression. Vitamin D deficiency has also been associated with increased toxicity from bisphosphonate therapy. The optimal dose of vitamin D supplementation is unknown, but daily sunlight exposure can generate the equivalent of a 10,000-IU oral dose of vitamin D 3 . This study therefore aimed to assess the effect of this dose of vitamin D 3 in patients with bone metastases from breast cancer. METHODS: Patients with bone metastases treated with bisphosphonates were enrolled into this single-arm phase 2 study. Patients received 10,000 IU of vitamin D 3 and 1000 mg of calcium supplementation each day for 4 months. The effect of this treatment on palliation, bone resorption markers, calcium metabolism, and toxicity were evaluated at baseline and monthly thereafter. RESULTS: Forty patients were enrolled. No significant changes in bone resorption markers were seen. Despite no change in global pain scales, there was a significant reduction in the number of sites of pain. A small but statistically significant increase in serum calcium was seen, as was a significant decrease in serum parathyroid hormone. Treatment unmasked 2 cases of primary hyperparathyroidism, but was not associated with direct toxicity. CONCLUSIONS: Daily doses of 10,000 IU vitamin D 3 for 4 months appear safe in patients without comorbid conditions causing hypersensitivity to vitamin D. Treatment reduced inappropriately elevated parathyroid hormone levels, presumably caused by long-term bisphosphonate use. There did not appear to be a significant palliative benefit nor any significant change in bone resorption. Cancer 2010;116:284-91.

No abstract

Patients with either progressive bone metastases or SREs while on clodronate or pamidronate may experience significant pain palliation with a switch to a more potent bisphosphonate. If confirmed by randomized trials, clinicians can start moving away from the paradigm whereby patients remain on a single bisphosphonate regimen throughout the course of their disease.