Finnish researchers reporting in the February 23 issue of the New England Journal of Medicine also found that patients who received infusions of trastuzumab (Herceptin) were less likely to get recurrences.

Advertisement

42% less recurrences
"There were 42 percent less breast cancer recurrences during the first three years of follow-up among women treated with docetaxel as compared to those who received vinorelbine," said Dr Heikki Joensuu, corresponding author and a physician at Helsinki University Central Hospital. "However, docetaxel was associated with more adverse effects [such as allergic reactions, swelling and fever]."

Death rates from breast cancer have gone down in recent years, partly due to the use of postoperative chemotherapy, and experts continually test new regimens to determine which drugs best reduce the risk of recurrence.

How the study was conducted
For this study, Joensuu and his colleagues randomly assigned more than a thousand women with breast cancer three cycles of either docetaxel or vinorelbine, followed by three cycles of other cancer drugs.

Then, a subgroup of 232 women whose tumours had an amplified HER2/neu gene - known to be associated with cancers that grow and spread more aggressively - were also assigned either to receive nine weeks of infusions of Herceptin or a placebo.

The researchers wanted to determine which regimen was best for recurrence-free survival.

58% fewer recurrences
Those who got the Herceptin experienced 58 percent fewer cancer recurrences during the three-year follow-up than those who didn't get the drug, the researchers report.

The docetaxel/vinorelbine results were especially important, Joensuu said. "No prior study has compared single-agent docetaxel with single-agent vinorelbine as adjuvant treatment of breast cancer," he noted.

The study agrees with previous research, Joensuu added. "A few prior studies have shown that administration of adjuvant trastuzumab [Herceptin] for one year reduces the rate of breast cancer recurrence approximately by 50 percent in the subset of women who have HER2-positive breast cancer," he said. But those studies also found Herceptin to be linked with an increased risk for cardiac failure; that was not the case in this latest study.

Significantly reduced time on drug
However, the Herceptin was given over a much shorter time period - nine weeks vs. a year in the previous trials.

Another expert said the study confirms previous research, but also breaks new ground regarding Herceptin use.

"It is the first to use such a short course," said Dr Mark Pegram, director of the women's cancer program at the Jonsson Cancer Centre at the David Geffen School of Medicine at UCLA. "We don't know the optimal duration of trastuzumab - is nine weeks as good as one year?" That question remains to be confirmed, he said.

If the nine-week regimen turns out to be ideal, Pegram said, "it could be very good news for patients," sparing them time and much expense. – (HealthDayNews)

Visit our Breast Centre for more information.

February 2006
 

Print this article on

Rate this article Poor 1 2 3 4 5 Excellent

JOBS

Civil Engineering Technician Gauteng - Johannesburg Staff Nurse Western Cape ICU Registered Nurse Western Cape Maternity Ward Nurse Western Cape Senior Financial Manager CA (SA) R600,000-650,000 Per Annum Cost To Company Gauteng - Johannesburg Senior Financial Manager CA (SA) R600,000-650,000 Per Annum Cost To Company Gauteng - Johannesburg Business Development Manager R400,000-550,000 Per Annum Cost To Company Gauteng - East Rand Cost / Clinical Audit Clerk (Medical Aid) Western Cape Find more jobs Register your CV Post a job