Clinical trial shows timing of chemotherapy improves survival in breast cancer

New York, December 12, 2002 New research shows that giving doses of chemotherapy more frequently in time, leads to a significant improvement in survival with no increase in toxicity in women with node-positive breast cancer. The study, coordinated by the Cancer and Leukemia Group B (CALGB) for the National Cancer Institute's Breast Intergroup, found a 31 percent decrease in the death rate with more frequent chemotherapy administration, called "dose dense," compared to conventional treatment. The findings will be presented today at the 25th Annual San Antonio Breast Cancer Symposium.

"Since breast cancer is so common, and adjuvant drug therapy has already been found to be so effective, a way to make that treatment 31 percent more effective could potentially save thousands of lives per year in the United States alone," said Larry Norton, MD, Head of the Division of Solid Tumor Oncology at Memorial Sloan-Kettering Cancer Center, and senior author of the study.

A mathematical model called the Norton-Simon hypothesis formed the basis for the concept of dose density and another concept tested in this study, sequential therapy. The model, developed by Dr. Norton, and Richard Simon of the National Cancer Institute, was used to address the question: "Is it better to use a higher dose of a drug less often or a lower dose more frequently?" According to Dr. Norton, the answer depended upon the efficacy of the drugs and the pattern of growth of the disease, and could not be answered without a mathematical understanding of the underlying biology.

The study enrolled 2005 women with primary breast cancer that had spread to the lymph nodes, and with no other metastases. They were randomized post-operatively to one of four treatments. Two groups of patients were randomized to receive doxorubicin (A for Adriamycin), paclitaxel (T for Taxol), and cyclophosphamide (C for Cytoxan) sequentially, i.e., one at a time, in two- or three-week c

Contact: Christine Hickey
Memorial Sloan-Kettering Cancer Center

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