Substantial 15-year survival gains from standard breast cancer ...( moxifen also reduces the breast cancer ...),Health

moxifen also reduces the breast cancer death rate over the next 10 or 15 years by about one third. For middle-aged women with hormone-sensitive disease, a combination of both of these treatments halves the breast cancer death rate. The authors note that while chemotherapy and tamoxifen can have unpleasant short-term side-effects, any long-term side effects are much smaller than the long-term survival benefits.

The analysis is restricted to trials that began by 1995, so none of the available studies involved taxanes, trastuzumab, or modern aromatase inhibitors.

Professor Sarah Darby (Clinical Trial Service Unit, University of Oxford, UK), who helped co-ordinate the collaboration, comments: "For middle-aged women with hormone-sensitive breast cancer, six months of anthracycline-based chemotherapy and five years of tamoxifen halves the long-term risk of death from the disease. Such treatments have been used widely for several years and were endorsed by a US consensus panel in 2001. Although newer treatments are now gaining favour, the eventual long-term benefits from older treatments such as these are one of the main reasons why breast cancer mortality rates are now falling rapidly in countries such as the UK or USA."

She adds: "This is the largest analysis of randomised evidence ever done in any type of cancer. Because so many women in previous decades agreed to join these randomised trials, millions of women in future decades will benefit." (Quote by e-mail; does not appear in published paper)

In an accompanying comment Karen Gelmon (British Columbia Cancer Agency, Vancouver, Canada) and colleagues state: "The most impressive finding is the divergence of the survival curves for breast cancer over timeThe survival curves suggest that adjuvant systemic therapies do cure a proportion of women with early-stage breast cancer, rather than simply delaying recurrence; a finding that is reassuring to both oncologists and patients after 30 year
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Contact: Joe Santangelo
j.santangelo@elsevier.com
1-212-633-3810
Lancet
12-May-2005

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