Bone drug boosts breast cancer survival

Women who go on a low carb diet just two days per week have a lower risk of developing breast cancer compared to those who follow a standard calorie-restricted diet every day of the week, in order to lose weight and lower their insulin blood levels. Long-term high blood insulin levels are known to raise cancer risk. These findings were presented by scientists from Genesis Prevention Center at University Hospital in South Manchester, England, at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium.


The researchers stressed that a larger, longer-term additional study is required.


Michelle Harvie, Ph.D., SRD, a research dietician at the Genesis Prevention Center, who presented the study said:


"Weight loss and reduced insulin levels are required for breast cancer prevention, but [these levels] are difficult to achieve and maintain with conventional dietary approaches."




Harvie and her team set out to compare three different 4-month-long diets to assess the effects on weight loss and blood markers of breast cancer risk in 115 women who had a family history of breast cancer. The researchers randomly assigned patients into three groups:
The low cal/carb group - they followed a calorie-restricted, low-carbohydrate diet
The part-time low-carb group - they followed an "ad lib" low-carbohydrate diet whereby patients were allowed to consume unlimited proteins and healthy fats, like lean meats, olives and nuts for 2 days per week.


"The benefit persists" long after treatment ends, said study leader Dr. Michael Gnant of Austria's Medical University of Vienna. He presented the research this week at the San Antonio Breast Cancer Symposium.
Zometa (zow-MAY-tuh) should now be offered to all patients like those in this study — younger women forced into early menopause by hormone-blocking cancer treatments, some specialists said.
"It's a new standard of care," said Dr. James Ingle, a Mayo Clinic breast specialist who had no role in the study.
Bone drugs called bisphosphonates — sold as Fosamax, Boniva and Actonel — have long been sold for treating osteoporosis. Those are daily pills. Zometa, made by the Swiss company Novartis AG, is given intravenously to treat cancer that has spread to the bone.
Hope that it could do more grew in 2008, when Gnant reported that it lowered the risk of a cancer recurrence in a study of 1,800 premenopausal women with early-stage breast cancer. All had surgery followed by hormone blockers, and half also received Zometa.
Now, with seven years of follow-up, researchers see that Zometa not only helped keep cancer from coming back, but also improved survival. There were 33 deaths among women given the bone drug and 49 among those not treated with it.
That magnitude of benefit is comparable to many chemotherapy treatments. Researchers think because Zometa strengthens bones, it's tougher for cancer to spread there and the drug may also have direct effects against circulating cancer cells or microscopic tumors.
Zometa's side effects were mostly fever and bone and joint pain, and doctors saw no cases of jawbone decay, a serious problem long linked to bisphosphonates. Zometa costs more than $1,000 in the U.S. and about half as much in Europe, though the price may drop when its U.S. patent expires in 2013. Novartis helped pay for the study and Gnant consults for the company.
The bone drug proved disappointing though in a large study last year in postmenopausal women, who account for three-fourths of all breast cancers. But there was a glimmer of hope in the oldest patients.
"They benefitted substantially as long as they were well past menopause," said Dr. Peter Ravdin, director of the breast cancer program at the UT Health Science Center in San Antonio, who also had no role in the research.



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