|
E-mail this page to a friend!
Senior Citizen Health & Medicine
Targeting Chemotherapy for Breast Cancer Can Save
Needless Suffering
HER-2 status predicts success of chemotherapy in
breast cancer treatment, study finds
Oct. 11, 2007 Researchers have found they can
potentially target chemotherapy for
breast cancer to only those women most likely to benefit, sparing
the majority of patients from unnecessary side effects.
The multicenter study, led by
University of Michigan Comprehensive Cancer Center researchers,
found women whose breast cancer expressed a protein called HER-2 were
most likely to benefit from adding the drug Taxol to the chemotherapy
regimen, while women whose tumors were fueled by estrogen but did not
express HER-2 did not get any benefit from the added Taxol. About 15
percent to 20 percent of breast cancers express HER-2, and as many as
three-quarters of breast cancers are so-called
estrogen-receptor-positive.
| |
Related Stories |
|
| |
Xeloda
Tablet Improves Survival Rate from Colon Cancer Versus Chemo
Oral medicine approved in U.S. to also treat
metastatic breast cancer
Oct. 8, 2007
Cancer Care for Growing Elderly Population Poses
International Time Bomb
Well educated, internet savvy elderly will be more
capable of demanding optimal care
Sept. 26, 2007
Aromatase Inhibitors Lead in Improved Survival with
Metastatic Breast Cancer
Aromatase inhibitors help block tumor growth by
lowering estrogen
July 23, 2007
Researchers Alarmed by Declining Mammography Use
Among Older Women
Years of increased use was followed by decline in
breast cancer mortality
May 14, 2007
Aromatase Inhibitor Hormone Drugs Make Survival
Difference in Advanced Breast Cancer
Review of studies of 10,000 older women say it
is better for patients
January 30, 2007
Genetic Breast Cancer Assessment Eases Stress for
Women at Risk
Demand leads to opening of genetic cancer clinics
April 18, 2007
Shutting Down Genetic Gang of 4 Slows Spread of
Breast Cancer Almost to Halt
Silencing quartet nearly completely
stopped
tumor growth, spread
April 11, 2007
Computer-Aided Detection Reduces the Accuracy of
Mammograms
Women screened by CAD devices more likely to
undergo a biopsy
April 5, 2007
Women Found with Cancer in One Breast Should Use MRI
to Screen the Other
Other testing missed cancers found by magnetic
resonance imaging
March 28, 2007
Read the latest news on Senior
Health & Medicine |
|
Results of the study appear in the Oct. 11 issue of
the
New England Journal of Medicine.
In general,
chemotherapy for breast cancer has been a one-size-fits-all
approach,says lead study author
Daniel Hayes, M.D., clinical director of the breast oncology program
at the U-M Comprehensive Cancer Center.
"Our decision to recommend it is based on whether a
woman is at high risk of the breast cancer recurring, without any idea
of whether she would benefit from the additional therapy. With this data
we hope we will be able to focus chemotherapy on patients whom its most
likely to help.
Hayes was the lead investigator
on the study, which was run by the
Cancer and Leukemia Group B through the
Breast Cancer Intergroup of North America.
The study looked at tissue samples and data from
1,500 women who had previously participated in a study looking at the
benefit of adding Taxol after four cycles of the drugs Adriamycin and
Cytoxan, so-called AC chemotherapy. Cancer had spread to the lymph nodes
in all of the women, which is a standard indication to recommend
chemotherapy.
All the women were given AC chemotherapy for four cycles,
after which half the women received four cycles of Taxol and the other
half did not receive any more chemotherapy. A previous analysis had
shown that adding Taxol decreased the chances of cancer recurring and
improved survival when all patients were considered, with no
consideration of HER-2 status.
But, previous studies have also suggested that
women whose tumors were estrogen-receptor-positive did not seem to
benefit as much from chemotherapy as those women whose tumors do not
need estrogen.
In this recent analysis, researchers found that the
addition of Taxol improved survival rates in women who were
HER-2-positive, regardless of their estrogen receptor status. But women
whose tumors were HER-2-negative and estrogen-receptor-positive had no
additional benefit from the paclitaxel. More than half of the patients
in the study fell into this category.
The researchers do not recommend a change in
treatment at this point, stating that more research must be done to
confirm that Taxol does not benefit estrogen-receptor-positive breast
cancer.
This is the first such observation thats been
made, and it was made retrospectively, meaning we looked backwards
instead of forwards. We are not recommending at this time that women
with positive lymph nodes, for whom we would currently recommend Taxol,
but who are estrogen receptor positive and HER-2 negative not take the
Taxol. We think the stakes are too high, Hayes says.
Weve seen mortality from breast cancer dropping
in recently years because weve applied these new and better therapies.
But now we believe, if these results are confirmed and validated in
other studies, that perhaps we could pull out half the patients in that
study and save them from the toxicities and the cost of receiving a drug
that might not do them any good, he continues.
Doctors have been able to use newer drugs, such as
tamoxifen, aromatase inhibitors or Herceptin, to treat only some women
with breast cancer, based on whether their tumor expresses estrogen
receptor or HER-2. But this method of targeting treatment had not been
possible with traditional chemotherapy.
This new study suggests doctors
might be able to consider estrogen receptor status and HER-2 status
together to determine what treatment will be most effective, sparing
some women from the toxic side effects of drugs that are not likely to
be effective.
Determining who doesnt need chemotherapy and can
be spared some portion of toxic therapy is one of the biggest issues
facing breast cancer today, says senior study author Donald Berry,
Ph.D., professor and head of the Division of Quantitative Sciences at
The
University of Texas M. D. Anderson Cancer Center.
In oncology, we
are very good at adding therapies to a patients regimen, but we are not
as confident subtracting treatment. Hopefully, in time, well be able
to limit therapies to those that will truly benefit from the additional
regimen.
Important Note for patients:
The researchers
caution that they are not suggesting a change in recommended treatment
based on these study results. Patients with questions about their
specific treatment should consult their oncologists. For general
questions about breast cancer treatment options, call the U-M Cancer AnswerLine at 800-865-1125.
Editor's Notes:
In addition to Hayes and Berry, study authors were
Ann Thor, M.D., from the University of Colorado; Lynn Dressler, Dr.Ph.,
David Cowan and Susan Edgerton all from the University of North
Carolina, Chapel Hill; Donald Weaver, M.D., from the University of
Vermont; Gloria Broadwater, Duke University; Lori Goldstein, M.D., from
Fox Chase Comprehensive Cancer Center; Silvana Martino, D.O., from the
Angeles Clinic and Research Institute; James Ingle, M.D., from the Mayo
clinic; I. Craig Henderson, M.D., from the University of California at
San Francisco; Larry Norton, M.D., and Clifford Hudis, M.D., both from
Memorial Sloan-Kettering Cancer Center; Eric Winer, M.D., from the
Dana-Farber Cancer Institute; and Matthew Ellis, Ph.D., from Washington
University.
Funding for the study was from the
National Institutes of Health, the
Breast Cancer Research Foundation, the
National Cancer Institute and the Fashion Footwear Charitable Foundation
of New York/QVC Presents Shoes on Sale.
>> More about
Daniel Hayes, M.D.
>>
University of Texas M. D. Anderson Cancer Center
>>
University of Michigan Comprehensive Cancer Center
>>
Cancer and Leukemia Group B
>>
Breast Cancer Intergroup of North America.
Reference:
New England Journal of Medicine: New England Journal of Medicine, Vol.
357, No. 15, Oct. 11, 2007
Written by: Nicole Fawcett
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
