New Breast Cancer
Study Shows Hormonal Therapy after Surgery is Not Enough
Behind the Cancer Headlines®
Many postmenopausal women with hormone-dependent breast cancer (requires estrogen and/or progesterone to grow) may be undertreated if they do not receive chemotherapy in addition to hormonal therapy after surgery, according to a Loyola University Health System study.
Loyola's Dr. Kathy S. Albain presented the results of a 10-year follow-up of The Breast Cancer Intergroup of North America Trial 0100 at the San Antonio Breast Cancer Symposium annual meeting.
"The research shows that, in many cases, tamoxifen or other hormonal therapy alone is not optimal," said principal investigator and first author Albain, a professor of hematology/oncology at the Loyola University Chicago Stritch School of Medicine.
"Overall, chemotherapy helped stop the cancer from recurring in postmenopausal women with receptor-positive breast cancer that has spread to the lymph nodes," said Albain. "This survival advantage was greatest when tamoxifen followed chemotherapy, rather than given concurrently.
"Ten-year disease-free-survival estimates were 48 percent for those treated with tamoxifen alone; 53 percent for concurrent chemohormonal therapy; and 60 percent for sequential therapy," said Albain.
Albain and colleagues conducted a 10-year follow-up of 1,477 patients. A total of 550 patients received concurrent chemohormonal therapy (CAFT) (cyclophosphamide, doxorubicin, 5-fluorouracil, tamoxifen); another 566 patients received sequential chemohormonal therapy (CAF-T); and 361 patients received tamoxifen alone.
"Long-term follow-up of this large North American trial confirms that chemotherapy benefits postmenopausal women with hormone-dependent breast cancer," said Albain. "We discovered that women with very high levels of estrogen receptor in their tumors can probably avoid chemotherapy, but those with lower or intermediate levels benefit from it over and above tamoxifen.”
She added that a second aspect of this study explored the use of various molecular markers measured on the breast tumor to predict the added value of chemotherapy. The purpose of this was to determine if the individual's biologic profile on an individual tumor would enable doctors to tailor therapy more specifically.
"These results will help current breast cancer treatment in that we are moving to regimens tailored to the specific individual's cancer and it will stimulate future research," said Albain.
SOURCES:
San Antonio Breast Cancer Symposium,