Older cancer drugs improved breast cancer survival
- From: J <nswex@nalid;non>
- Date: Sun, 06 Jan 2008 06:27:36 -0500
Older cancer drugs improved breast cancer survival
Posted: January 4, 2008
NEW YORK (Reuters Health) - A review of published clinical trials
indicates that adjuvant chemotherapy regimens - drug therapy administered
after surgical removal of the cancer -- used in the 1970s and 1980s safely
improved the long-term survival of women with breast cancers associated
with poor outcomes.
The authors of the report, published in The Lancet, believe that current
and future chemotherapy regimens are likely to yield even greater
improvements in survival for women with estrogen-negative breast cancer.
This type of breast tumor does not respond to treatment as well as
estrogen-positive tumors do.
"This latest update from the Early Breast Cancer Trialists' Collaborative
Group further confirms the contribution of chemotherapy to the decreasing
recurrence of estrogen receptor-negative breast cancer," Dr. Rinat
Yerushalmi and Dr. Karen Gelmon, from the British Columbia Cancer Agency
in Vancouver, comment in a related editorial
Dr. Richard Peto, from the University of Oxford in the UK, and colleagues
analyzed data on roughly 6,000 women with estrogen receptor-poor breast
cancer enrolled in 46 trials comparing adjuvant chemotherapy with no
chemotherapy and from about 14,000 women enrolled in 50 trials comparing
tamoxifen with no tamoxifen.
The chemotherapy regimens were used in trials starting between 1975 and
1996, were not based on taxane and typically involved six cycles. Taxanes
are a class of drugs found to be very effective for breast cancer, but
drugs in this class were not approved for use by the United States FDA
until the 1990s. In the tamoxifen trials, which started between 1972 and
1993, the drug was given with or without chemotherapy depending on the
study.
Treatment with chemotherapy was associated with significant reductions in
breast cancer recurrence and mortality in women younger than 70 years of
age at trial entry. For instance, in women younger than 50 years, the
10-year risks of recurrence with and without chemotherapy were 33 percent
and 45 percent, a significant difference. The corresponding breast cancer
mortality rates were 24 percent and 32 percent.
The chemotherapy regimens were also deemed safe, as no increase in
all-cause mortality was seen with their use.
Tamoxifen, by contrast, had little effect on breast cancer recurrence or
mortality in women with estrogen receptor-poor disease. Moreover, no
significant interaction was noted between tamoxifen and chemotherapy.
"Efforts should now be directed towards the establishment of finer
definitions of subtypes of (estrogen-receptor negative) breast cancers,
the study of less debilitating but active regimens and the development of
new strategies for those who are not cured by conventional chemotherapy,"
Yerushalmi and Gelmon conclude.
.
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