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DG DISPATCH - USCAP: Taxanes Promote Necrosis In Advanced Breast Cancer By Emma Patten-Hitt Special to DG News ATLANTA, GA -- March 7, 2001 -- Taxanes, such as Taxol, may promote a large degree of necrosis in locally advanced breast tumors, probably by inhibiting angiogenesis, according to researchers. Dr. Susan Fineberg and colleagues from the Montefiore Medical Center in Bronx, New York presented these findings, yesterday, March 6 at the United States and Canadian Academy of Pathology annual meeting in Atlanta, Georgia. In the study, 37 women with locally advanced breast cancer undergoing chemotherapy were either treated with adriamycin (23 patients) or both adriamycin and Taxol (14 patients). Patients receiving both adriamycin and Taxol showed a 93 percent clinical response rate, whereas patients receiving adriamycin alone showed only a 66 percent response rate. The researchers also found that about 60 percent of tumors of women receiving taxanes had necrotic tissues, whereas almost none of the adriamycin-only patients showed a necrotic response. “We had never seen this level of necrosis before,” Dr. Fineberg told Doctor's Guide, who said she was surprised by the amount she saw. According to Dr. Fineberg, the necrotic response to taxanes may be a result of the anti-angiogenic properties of taxanes, but she also noted that "whether tumor necrosis is a good thing or not is another issue." Estrogen receptors (ER) may play a role in the necrotic response, according to the researchers. Tumors that were ER-negative generally showed a necrotic response, whereas tumors that were ER-positive did not generally show a necrotic response. "This may reflect the relationship between ER activation and upregulation of VEGF (vascular endothelial growth factor), which promotes angiogenesis," Dr. Fineberg said. The researchers also found that patients who showed a necrotic response in their breast tumors did not have any residual tumors in their axillary lymph nodes, but patients who failed to show a necrotic response did have residual tumor in their axillary lymph nodes. Dr. Fineberg pointed out that this observation could have important clinical implications. "The important point is that with taxanes, you can expect to find large areas of tumor necrosis in a significant number of patients," Dr. Fineberg said, "but whether or not this has a positive or negative impact, overall, still remains to be seen," she added. E-mail this page to a friend or colleague! To print, use this version