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Newer chemotherapies improve outcomes for some types of breast cancer

CHICAGO An updated analysis of findings from three major consecutive clinical trials of breast cancer treatment conducted over the past twenty years indicates that women who have breast cancer with lymph node involvement and estrogen-receptor negative tumors have a lower rate of recurrence and risk of death with treatment with newer chemotherapies, according to a study in the April 12 issue of JAMA.

Breast cancer estrogen-receptor status (ER how cells respond to specific hormonal therapies) helps identify patients who benefit from endocrine therapy. With appropriate endocrine therapy, patients with ERpositive disease have substantially better prognoses as a group than do those with ERnegative disease. Evidence is accumulating that improvements in chemotherapy disproportionately benefit patients with ERnegative tumors.

Donald A. Berry, Ph.D., of the University of Texas M. D. Anderson Cancer Center, Houston, and colleagues examined whether breast cancer patients who have lymph node involvement and ERnegative tumors benefit more from recent improvements in supplemental chemotherapy than do women with ERpositive tumors treated with tamoxifen. The researchers compared disease-free and overall survival according to ER status among 6,644 patients enrolled in three consecutive randomized trials of chemotherapy conducted by the Cancer and Leukemia Group B and the U.S. Breast Cancer Intergroup. The trials compared (1): three regimens of cyclophosphamide, doxorubicin, and fluorouracil (January 1985 to April 1991); (2) three doses of doxorubicin concurrent with cyclophosphamide, with or without subsequent paclitaxel (May 1994 to April 1997); (3) sequential doxorubicin, paclitaxel, and cyclophosphamide with concurrent doxorubicin and cyclophosphamide followed by paclitaxel, and also three-week vs. two-week cycles (September 1997 to March 1999).

The researchers found that for ERnegative tumors, chemotherapy improvements reduced the relative risk of re
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Contact: Nancy Jensen
713-792-0655
JAMA and Archives Journals
11-Apr-2006


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