SAN ANTONIO, TEXAS - High-dose chemotherapy and autologous stem cell transplantation, the controversial, arduous, yet once-popular combination treatment that fell out of favor as a therapy for breast cancer, has proven not to be beneficial as an adjuvant therapy for women with node-positive disease, according to an expansive analysis conducted by researchers at The University of Texas M. D. Anderson Cancer Center.
In a review of 15 randomized high-dose chemotherapy studies conducted around the world between 1988 and 2002, the investigators from M. D. Anderson, in collaboration with the European Blood and Marrow Transplant Group, report that while there was a slight benefit on relapse-free survival, there was no benefit to overall survival. Donald Berry, Ph.D., professor and head of the Division of Quantitative Sciences, presented the findings today at the 30th annual San Antonio Breast Cancer Symposium.
"Of all cancers, breast cancer is one of the most sensitive to treatment, resulting in a dramatic mortality decrease in the U.S. in recent years," says Berry. "Frequently, in recent breast cancer history, when we have run studies of adjuvant therapy for node- positive breast cancer, the findings have shown that an innovation indeed delays recurrence and prolongs survival. For example, we've shown that increasing doses of the chemotherapy regimen FAC within the standard dose range improves overall survival and disease-free survival. We've shown the same for the addition of paclitaxel. We've also proved that dose density, in terms of delivery every two weeks versus every three weeks, improves overall survival.
"All of these studies suggest the more you do, the better. It's clear to me that delivering more chemotherapy must benefit some patients. Yet, there is a limit and we seem to have reached a plateau."'
Adjusting for demographics, clinical characteristics, intensity of therapy, estrogen receptor status, Berry thought the
|Contact: Laura Sussman|
University of Texas M. D. Anderson Cancer Center