Navigation Links
Adding Chemo to Tamoxifen Helps Some Breast Cancer Patients
Date:12/10/2009

Combo extended survival for certain women with estrogen-positive tumors, study found

THURSDAY, Dec. 10 (HealthDay News) -- Adding chemotherapy to standard cancer-suppressing tamoxifen can boost survival in postmenopausal women with the most common type of breast cancer, known as estrogen receptor-positive, and it's best given before the tamoxifen regimen starts, according to a new study.

"Chemotherapy with Adriamycin adds to your survival benefit over and above what tamoxifen would do if you are postmenopausal and have positive lymph nodes and estrogen receptor-positive cancer [the most common type]," explained Dr. Kathy Albain, the lead researcher and professor of medicine at Loyola University Chicago Stritch School of Medicine.

And in another study, Albain found that screening breast tumors with an available multi-gene test spots patients who may not need this form of chemotherapy, despite fitting the standard profile.

Both studies are published online Dec. 10, the first in the journal The Lancet and the second in The Lancet Oncology. Albain is also due to present her findings Thursday at the annual San Antonio Breast Cancer Symposium in San Antonio, Texas.

In estrogen receptor-positive cancer, tumor cells carry many receptors on their surfaces to which estrogen can attach, fueling tumor growth. Tamoxifen works by blocking the receptors.

Experts have long debated whether women with estrogen receptor-positive cancers -- whose growth is fueled by circulating estrogen -- would get more benefit from having a chemotherapy regimen on top of tamoxifen.

Albain led a research team from multiple centers that followed nearly 1,500 breast cancer patients for up to 13 years, with a median (half longer, half less) of nearly nine years. All were past menopause and had hormone receptor-positive cancer that had spread to at least one lymph node in the armpit area.

Albain's team assigned 381 women to tamoxifen alone, 587 to chemotherapy alone and 590 to both, with some receiving tamoxifen and chemo together and some in a sequential manner.

Tamoxifen was taken daily for five years. The chemo regimen used is called CAF, for "cyclophosphamide, Adriamycin and 5-fluorouracil."

In all, after accounting for study dropouts, 1,460 women received treatment.

The combined treatments of chemo plus tamoxifen increased the women's disease-free survival by 24 percent, Albain found. When her team looked at which delivery protocol worked best -- simultaneous tamoxifen and chemotherapy or chemo followed by tamoxifen -- the sequential approach was found to be better, giving slightly better disease-free survival.

Ten-year disease-free survival estimates were 57 percent for the combination group and 48 percent for the tamoxifen-only group, the researchers found.

However, women receiving chemo were more likely to have drops in white blood cells, important for fighting infections, the team noted. And they were also more prone to blood clots, congestive heart failure and other complications.

In a second study, Albain's team analyzed whether a gene test, called Oncotype DX, could predict which women would benefit from chemotherapy. Genomic Health, which makes the test, helped fund the study, along with the U.S. National Cancer Institute.

The test, which Albain said is already widely used, is done on the tumor itself. "This puts 21 genes together and comes up with a score," she said. The score -- low, intermediate, high -- predicts the risk of recurrence over 10 years if a woman used tamoxifen alone.

When the researchers performed the test on 367 specimens, they found a low score identified those women who may not need the chemo, despite the fact that they have cancer that spread to lymph nodes.

"This is a positive study, there's no question," said Dr. Joanne Mortimer, vice chair of medical oncology for the City of Hope Cancer Center in Duarte, Calif., of the first study. "This study tells us [that] if you have positive lymph nodes [and are postmenopausal with estrogen receptor-positive cancer], you should have both chemo and tamoxifen, because the survival was better."

But, she added, "when you give everyone [who has the estrogen receptor-positive, node-positive breast cancer] chemotherapy, probably there are some who don't need it."

According to Mortimer, that's why the gene test looks promising -- it may spare some women from having to have chemo while ensuring that those who will benefit from the treatment get it.

More information

To learn more about breast cancer, visit the American Cancer Society.



SOURCES: Kathy Albain, M.D., professor, medicine, Loyola University Chicago Stritch School of Medicine; Joanne Mortimer, M.D., vice chair, medical oncology, City of Hope Comprehensive Cancer Center, Duarte, Calif.; Dec. 10, 2009, presentation, San Antonio Breast Cancer Symposium, Texas; Dec. 10, 2009, The Lancet, The Lancet Oncology, online


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Adding Proton Therapy Boost to X-Ray Radiation Therapy Reduces Prostate Cancer Recurrences
2. Adding Chemo Helps Head, Neck Cancer Patients
3. Adding tools against breast tumors
4. Adding Drug Doesnt Help Control Blood Pressure
5. CutisPharma Launches New Prescription Mouthwash Kit Adding to Product Line
6. Adding a Stent May Help Resolve Brain Aneurysm
7. Dakim BrainFitness Now Used in 286 Senior Living Communities, Adding 136 Sites in 12 Months for Dementia-Fighting System
8. Hospital Improves Patient Experience by Adding Email and Web Access in Patient Rooms With Virtual Linux Desktops
9. Contracts adding legal twist to family health care
10. Takeda to Acquire IDM Pharma, Adding MEPACT(R) (Mifamurtide), the First Treatment Approved for Osteosarcoma in More Than 20 Years, to Its Oncology Franchise
11. CoolSign 4.3 Released Adding New Features for Digital Signage Networks
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... June 27, 2016 , ... "FCPX editors can now reveal ... Final Cut Pro X," said Christina Austin - CEO of Pixel Film Studios. ... Cut Pro X users can now reveal the media of their split screens ...
(Date:6/27/2016)... ... June 27, 2016 , ... ... today announced its strategic partnership with Connance, a healthcare industry leader providing ... companies’ proven, proprietary technology combine to provide health systems, hospitals and ambulatory ...
(Date:6/27/2016)... ... June 27, 2016 , ... TopConsumerReviews.com recently awarded their highest ... . , Millions of individuals in the United States and Canada wear eyeglasses. Once ... to both correct vision and make a fashion statement. Even celebrities use glasses as ...
(Date:6/26/2016)... ... , ... On June 10-11, 2016, A Forever Recovery, a holistic treatment center ... Breakfast Table in Battle Creek, MI, where the rehabilitation facility is located. This annual ... the world’s leading providers of cereal and other breakfast foods. Its residents often refer ...
(Date:6/26/2016)... ... June 26, 2016 , ... PawPaws brand pet supplements owned by ... to enhance the health of felines. The formula is all-natural and is made from ... the PawPaws Cat Kidney Support Supplement Soft Chews are Astragalus Root Extract ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... Research and Markets has announced the ... to 2022" report to their offering. ... patients with kidney failure, it replaces the function of kidneys ... blood and thus the treatment helps to keep the patient ... Increasing number of ESRD patients & substantial ...
(Date:6/23/2016)... -- Research and Markets has announced the addition ... - Forecast to 2022" report to their offering. ... to date financial data derived from varied research sources to ... potential impact on the market during the next five years, ... of sub markets, regional and country level analysis. The report ...
(Date:6/23/2016)... INDIANAPOLIS , June 23, 2016 /PRNewswire/ ... Diabetes Tomorrow,s Leaders Scholarship is any indication, the future ... today online at www.diabetesscholars.org by the Diabetes ... stand in the way of academic and community service ... scholarship program since 2012, and continues to advocate for ...
Breaking Medicine Technology: