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Research Briefs

	Some tumors resistant to tamoxifen
	Hormone therapy does not help quality of life
	Schizophrenia study focuses on cost/benefit of new class of drugs

Some tumors resistant to tamoxifen

High levels of two proteins known to affect the growth of breast cancer cells also inhibit the cancer-fighting potential of tamoxifen, a drug used to prevent recurrence and new breast cancers in women at risk, said researchers from Baylor College of Medicine in a report published in the March 5 issue of the Journal of the National Cancer Institute.

C. Kent Osborne, MD, director of the Breast Center at Baylor, and his collaborators found that when the proteins AIB1 (Amplified in Breast Cancer-1) and HER-2 are present in high levels in the cells of women who have had breast cancer, their tumors are resistant to the cancer-fighting effects of tamoxifen.

“In fact, tamoxifen might have an adverse effect,” said Osborne. The finding could be important in predicting which women will respond to tamoxifen therapy. Before the finding can be used in patient treatment, it must be confirmed in studies with more patients, he said.

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Hormone therapy does not help quality of life

Combination hormone therapy does not improve quality of life for postmenopausal women, according to the Women’s Health Initiative study in the March 17 online edition of the New England Journal of Medicine.

The paper is the second released by the WHI since July 2002, when researchers reported that the combination of estrogen and progestin increased a woman’s risk of heart attack, breast cancer and stroke. These findings prompted the National Institutes of Health to halt the study nearly three years early.

“There was no benefit of being in the combination hormone group in terms of general health, energy, mental health, depression, memory or sexual functioning after one year,” said Jennifer Hays, PhD, lead author of the study and director of the Center for Women’s Health at Baylor College of Medicine.

A total of 16,608 postmenopausal women 50 to 79 years old were randomly assigned to receive daily estrogen plus progestin or placebo. Researchers collected information about the participants’ quality of life after one year and from a smaller subgroup of 1,511 women at three years.

Participants were asked questions about their general health, mental and physical health, role limitations associated with their physical or emotional health, bodily pain, energy and fatigue, ability to function in daily interactions, depression, memory, sleep disturbances, and satisfaction with sexual function. Even among the youngest women who had moderate to severe symptoms, the only benefit was a 5 percent improvement in sleep disturbances after one year.

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Schizophrenia study focuses on cost/benefit of new class of drugs

Determining the best medication to treat schizophrenia is the subject of a new clinical trial at Baylor College of Medicine.

The department of psychiatry at Baylor, in conjunction with Ben Taub General Hospital, is one of 90 clinical sites across the United States participating in the Clinical Antipsychotic Trials of Intervention Effectiveness, or CATIE, project. It is one of the largest studies ever funded by the National Institute of Mental Health (NIMH).

The federally funded study aims to determine the value of the new class of atypical antipsychotic drugs represented by clozapine, risperidone, olanzapine, quetiapine and ziprasidone. Up to 1,600 people with schizophrenia will participate in the study nationwide. Completion of the study is set for September 2004.

Unlike first-generation antipsychotics that act primarily on the brain's dopamine system, the newer medications studied by the CATIE project also act on serotonin and nonrepinephrine systems. However, they cost at least 10 times more than the first-generation antipsychotics and their relative effectiveness is unknown. CATIE results will help determine if they are more effective and whether they are worth the higher price. Participants in the schizophrenia trial are given support and comprehensive clinical care.

"It is essential that we determine which medications provide the best treatment for symptoms, such as hallucinations and psychosis, with the fewest side effects," said John Burruss, MD, principal investigator for the trial at Baylor and an assistant professor of psychiatry at Baylor and chief of psychiatry at Ben Taub.

For more information call (713) 873-2681.

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