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Two studies discussed at the annual meeting of the American Society of Clinical
Oncology (ASCO) may help improve the use of chemotherapy in
breast cancer patients. The first study finds that the drug Taxotere (generic name, docetaxel) significantly
reduces the chances that early-stage breast cancer will return after treatment. Meanwhile,
the second study finds that chemotherapy administered before the drug tamoxifen (brand name, Nolvadex) can benefit breast cancer
patients more than if the treatments are given at the same time after breast cancer
surgery. An ASCO spokesperson said the two studies will influence the treatment of
thousands of breast cancer patients.
Chemotherapy involves the use of anticancer drugs to help control or prevent the growth
of tumors. The treatment is often used as an adjuvant (supplemental) therapy in breast
cancer patients, in addition to surgery, radiation,
drugs, or other therapies.
In the first study discussed at the ASCO meeting, researchers studied the effectiveness
of the chemotherapy drug Taxotere in 1,500 early-stage breast cancer patients (Taxotere is
often used in patients with advanced, metastatic breast cancer).
Researcher Jean-Marc Nabholtz, MD, Chairman of the Breast Cancer International Research
Group, and his colleagues analyzed the use of Taxotere in combination with doxorubicin
(brand name, Adriamycin) and cyclophosphamide (brand name, Cytoxan) in one-half of the
women. This treatment regimen is called TAC. They then compared the TAC chemotherapy
regimen with another standard regimen called FAC (5-fluorouracil plus doxorubicin and
cyclophosphamide), which was given to the other 750 women in the study. All of the women
had previously undergone surgery to remove their breast tumors.
After following the women for three years, the researchers found that Taxotere (when
combined with doxorubicin and cyclophosphamide) reduced the risk of a recurrence of breast cancer by 32%, compared to the
standard FAC chemotherapy regimen. According to Dr. Nabholtz and his colleagues, the TAC
chemotherapy regimen was especially beneficial in early-stage breast cancer patients who
had one to three cancerous lymph nodes. Side effects of
both chemotherapy regimens could be successfully controlled.
While the first study discussed at the ASCO meeting dealt with the type of
chemotherapy, the second study involved the sequence of chemotherapy in relation to
other treatments. In particular, researchers of the second study found that women who
receive both chemotherapy and the drug tamoxifen after surgery benefit more from receiving
the chemotherapy before tamoxifen therapy.
"Many women in the United States receive tamoxifen and chemotherapy together after
surgery," said Kathy S. Albain, MD, Director of Breast Cancer Research and
Co-Director of the Breast Care Center at Loyola University Cardinal Bernardin Cancer
Center in Chicago, in an ASCO statement. "Our results show that it is best to wait
until chemotherapy is finished before starting tamoxifen to obtain optimal benefit from
the chemotherapy."
In the study, researchers compared three groups of breast cancer patients (a total of
1,477 women): those who received tamoxifen after chemotherapy, those who received
tamoxifen and chemotherapy at the same time, and those who only received tamoxifen. After
eight years of follow-up, Dr. Albain and her colleagues found that 67% of the women who
received tamoxifen after chemotherapy had survived cancer-free, compared with 62%
of patients who received the two treatments at the same time, and 55% of patients who only
received tamoxifen.
According to William J. Gradishar, MD, who moderated a press conference on breast
cancer treatment advances, these two studies are likely to affect the treatment of many
breast cancer patients across the United States.
Additional Resources and References
- The studies referenced in this article were discussed at the annual meeting of the American
Society of Clinical Oncology (ASCO) in May 2002. The May 19, 2002 ASCO news release,
"Improvements in Breast Cancer Therapy," is available at http://www.asco.org/
- To learn more about chemotherapy for breast cancer, please visit http://www.imaginis.com/breasthealth/chemo.asp
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