Gary V. Burton

Bio: Gary V. Burton is an academic researcher from LSU Health Sciences Center Shreveport. The author has contributed to research in topics: Breast cancer & Cancer. The author has an hindex of 20, co-authored 78 publications receiving 1815 citations. Previous affiliations of Gary V. Burton include Louisiana State University & Louisiana State University in Shreveport.

Double-Blind, Randomized Trial Comparing the Efficacy and Tolerability of Fulvestrant Versus Anastrozole in Postmenopausal Women With Advanced Breast Cancer Progressing on Prior Endocrine Therapy: Results of a North American Trial

Abstract: PURPOSE: To compare the efficacy and tolerability of fulvestrant (formerly ICI 182,780) with anastrozole in the treatment of advanced breast cancer in patients whose disease progresses on prior endocrine treatment. PATIENTS AND METHODS: In this double-blind, double-dummy, parallel-group study, postmenopausal patients were randomized to receive either an intramuscular injection of fulvestrant 250 mg once monthly or a daily oral dose of anastrozole 1 mg. The primary end point was time to progression (TTP). Secondary end points included objective response (OR) rate, duration of response (DOR), and tolerability. RESULTS: Patients (n = 400) were followed for a median period of 16.8 months. Fulvestrant was as effective as anastrozole in terms of TTP (hazard ratio, 0.92; 95.14% confidence interval [CI], 0.74 to 1.14; P = .43); median TTP was 5.4 months with fulvestrant and 3.4 months with anastrozole. OR rates were 17.5% with both treatments. Clinical benefit rates (complete response + partial response + stable ...

SWOG S0221: A Phase III Trial Comparing Chemotherapy Schedules in High-Risk Early-Stage Breast Cancer

Abstract: Purpose To determine the optimal dose and schedule of anthracycline and taxane administration as adjuvant therapy for early-stage breast cancer. Patients and Methods A 2 × 2 factorial design was used to test two hypotheses: (1) that a novel continuous schedule of doxorubicin-cyclophosphamide was superior to six cycles of doxorubicin-cyclophosphamide once every 2 weeks and (2) that paclitaxel once per week was superior to six cycles of paclitaxel once every 2 weeks in patients with node-positive or high-risk node-negative early-stage breast cancer. With 3,250 patients, a disease-free survival (DFS) hazard ratio of 0.82 for each randomization could be detected with 90% power with two-sided α = .05. Overall survival (OS) was a secondary outcome. Results Interim analyses crossed the futility boundaries for demonstrating superiority of both once-per-week regimens and once-every-2-weeks regimens. After a median follow-up of 6 years, a significant interaction developed between the two randomization factors (DFS ...

Patient Compliance Is Critical for Equivalent Clinical Outcomes for Breast Cancer Treated by Breast-Conservation Therapy

Abstract: Several studies have reported that the percentage of patients with breast carcinoma treated by breast-conservation therapy (BCT) is lowest in the southern region of the United States. 1–4 Socioeconomic factors, such as age, race, income level, access to regional treatment centers, and education level, have also been proposed as determinants of the use of BCT for the treatment of early breast cancer. 5–7 Based on carefully designed prospective randomized trials, the result of BCT for the treatment of early-stage breast cancer, as measured by local recurrence and overall survival, is equivalent to that of modified radical mastectomy. 8–11 The investigators from the National Surgical Adjuvant Breast and Bowel Project (NSABP B-06) concluded after a 12-year follow-up that no significant differences were found in overall survival, disease-free survival, or distant disease-free survival in patients treated by lumpectomy, axillary node dissection, and radiation therapy (XRT) compared with modified radical mastectomy. 10 Based on data from this and other prospective randomized trials evaluating BCT versus modified radical mastectomy, the National Institutes of Health issued recommendations after a consensus development conference that BCT with XRT was preferable for most women with stage I and II breast cancer. 12 Large clinical trials are performed under optimal conditions with excellent compliance and follow-up rates. The success of BCT is highly dependent on compliance with XRT to minimize the risk for local recurrence. In the reanalysis of the NSABP B-06 trial at 12 years of follow-up, patients treated with lumpectomy without XRT had a local failure (LF) rate of 35%. The LF rate was approximately 10% in patients treated with lumpectomy and XRT. These results were comparable to those of other clinical trials addressing the same issue. 9,10 The success of BCT is also highly dependent on clinical follow-up to identify, in a timely fashion, patients in whom local recurrence does develop. In the NSABP B-06 trial, patients with local recurrence underwent mastectomy, and this resulted in overall survival rates equivalent to modified radical mastectomy. 10 However, if local recurrence were not identified in a timely fashion by a clinical follow-up program, the chance for cure is likely to be reduced. Patients enrolled in clinical trials may not be representative of patients living in the various diverse communities that make up the United States. Regional access to healthcare and socioeconomic factors such as education level, cultural background, and personal income may have an impact on compliance. 4–7 Our hypothesis is that patients enrolled in clinical trials at the national level may not be representative of indigent patients in the rural South, and that clinical trial results may not be directly applicable. Thus, in this study, we intend to examine compliance with a BCT program and the resulting clinical outcomes in a population of primarily indigent patients served by a public hospital in the rural South. The objectives are to determine the compliance with a standard BCT program (XRT and clinical follow-up), to compare the clinical outcomes of these patients with those reported in clinical trials, and to examine the socioeconomic factors that may have contributed to the rate of compliance.

Harrison's Principles of Internal Medicine

Abstract: The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many