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Definitive study confirms chemo benefit in postmenopausal breast cancer
Date:12/10/2009

ANN ARBOR, Mich. Chemotherapy added to tamoxifen can improve outcomes for postmenopausal breast cancer patients, according to a landmark study by the Southwest Oncology Group.

But a related study presented today at the 2009 San Antonio Breast Cancer Symposium finds that a multigene test on tumors can identify a subset of patients who may not benefit from that chemotherapy.

Both studies were led by Dr. Kathy Albain, of Loyola University Health System. Both have just been published online, the first in the journal the Lancet, the second in the Lancet Oncology.

The studies report on a randomized phase III clinical trial of 1,477 postmenopausal women that was conducted at institutions across the U.S. and Canada by the University of Michigan-based Southwest Oncology Group (SWOG), one of the largest federally funded clinical trial networks. All of the women had estrogen receptor-positive (ER+) breast cancer that had spread to the lymph nodes under the arm, known as the axillary lymph nodes.

All women in the trial got daily tamoxifen for up to five years, long the standard therapy for treating ER+ breast cancer, the most common form of the disease. Estrogen latches on to receptors on these cancer cells and promotes tumor growth. Tamoxifen blocks those receptors, locking estrogen out.

Of the 1,477 women in the trial, 361 got only tamoxifen. The rest got tamoxifen plus a regimen of a three-drug chemotherapy treatment known as CAF (cyclophosphamide, Adriamycin, and 5-fluorouracil).

Albain's team reports in the Lancet paper that they saw long-term survival benefits for the women who received CAF chemotherapy. These women's risk of dying or having a cancer recurrence was 24% lower than it was for women who had gotten tamoxifen alone. The team also found that those who got the chemotherapy before the tamoxifen did better than those who got both simultaneously.

The CAF group had higher over
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Contact: Frank DeSanto
fdesanto@umich.edu
734-998-0114
University of Michigan Health System
Source:Eurekalert

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