Dual Treatment Doesn't Improve Outcomes of Breast Cancer Patients

By HospiMedica staff writers
Posted on 10 Jul 2003

A multicenter study has found that high-dose chemotherapy combined with stem cell implants do not improve survival of women with primary breast cancer that has spread to the regional nodes. The findings were reported in the July 3, 2003, issue of The New England Journal of Medicine.

Researchers studied 511 primary breast cancer patients whose tumor had spread to at last 10 lymph nodes under the arm. Half of the group was treated only with conventional chemotherapy for six months, while the other have received the same chemotherapy followed by high-dose chemotherapy and a stem cell transplant. All patients received three drugs: cyclophosphamide, doxorubicin, and fluorouracil. Those who also received the high-dose chemotherapy were given cyclophosphamide and thiotepa.

There were fewer relapses in the patient group who received the high-dose chemotherapy and the transplant, yet the overall results showed no significant difference in survival rates between the two groups. Moreover, nine of the 511 patients died of transplantation complications, and nine others developed myelodysplastic syndrome or acute myeloid leukemia.

"These results have enhanced our understanding of the disease and motivate us to explore alternatives to stem cell transplantation. It is evident that high-dose chemotherapy destroys more cancer cells, but its complications can also be deadly to patients,” said co-senior author Hillard M. Lazarus, M.D., professor of medicine at Case Western Reserve University (CWRU, Cleveland, OH, USA). The study was conducted at the CWRU and the Ireland Cancer Center at University Hospitals of Cleveland (OH, USA).

In a separate study in the same journal, researchers at the Netherlands Cancer Institute found a 10% greater relapse-free survival among women who received the high-dose chemotherapy and transplant versus conventional therapy. This benefit was most evident among women under 40 with HER2/neu-negative tumors.

Related Links:
Case Western Reserve University
Ireland Cancer Center at University Hospitals