Our group has a particular interest in endocrine therapy for breast cancer. We participated in a pivotal trial that resulted in the approval of fulvestrant, a pure anti-estrogen and estrogen-receptor downregulator for the treatment of metastatic breast cancer resistant to tamoxifen therapy. We also have been involved in recent chemotherapy trials utilizing traztuzumab in combination with paclitaxel (neoadjuvant therapy) and vinorelbine (both neoadjuvant therapy and metastatic disease), as well as a current trial testing the utility of pegfilgrastim in the support of dose-dense adjuvant chemotherapy. This trial administers four cycles of doxorubin plus cyclophosphamide and four cycles of paclitaxel at 2-week intervals.
In addition, we have been involved in the protocol titled Biomechanics of Metastases in Bone, a study to monitor the fracture risk of patients with metastatic breast cancer. In the past two years, over 1000 breast cancer patients have been evaluated for metastatic cancer to the spine, and approximately 100 patients have met the inclusion criteria for a prospective clinical study. In these patients we have demonstrated that the reduction in the load-carrying capacity of a bone with a lytic defect can be predicted non-invasively using computed tomography. An upcoming clinical trial will test the safety and preliminary efficacy of a humanized monoclonal antibody against human parathyroid-related protein in the prevention of skeletal events in metastatic breast cancer in comparison to zoledronic acid.