Berlin, Germany: Women with a particularly aggressive form of breast cancer seem to do better if they are treated with a combined anthracycline and taxane chemotherapy regimen before surgery, together with trastuzumab (Herceptin) before and after surgery, according to results from the largest multi-centre trial to investigate this treatment.
Professor Michael Untch told the 6th European Breast Cancer Conference (EBCC-6) in Berlin today (Friday) that the women in the trial did not suffer from any serious side effects of the treatment such as severe heart problems. These results are very challenging, as both trastuzumab and anthracyclines are associated with cardiac toxicity.
Prof Untch said: When we started this trial it was considered very courageous to give patients anthracyclines plus trastuzumab, but we wanted to expose patients to trastuzumab for as long as possible before surgery to make it as effective as possible. To minimise the risk, we excluded patients with any previous heart problems and excluded patients with ejection fractions of below 55%. However, our results showed no increase in toxicity for the combination chemotherapy plus trastuzumab compared with chemotherapy alone. There were no cases of congestive heart failure or cardiac-related deaths, and other cardiac-related symptoms were not severe. The combination chemotherapy plus trastuzumab proved to be the most effective combination, but, at the same time, we have to keep an eye on the heart. Therefore, cardiac monitoring every three months is a must for patients treated with this regimen.
A total of 1510 breast cancer patients were recruited to the GeparQuattro trial between 2006-2007; 453 of them had tumours that over-expressed the HER2 receptor (a particularly aggressive form of the disease). Before surgery they received four cycles of epirubicin/cyclophosphamide (EC) and were then randomised to receive either four cycles of docetaxel (D) or four cycles of D-capec
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ECCO-the European CanCer Organisation