another Time magazine error?

[Lani]

did Dr. Slamon say "no" benefit, or "small" benefit (which might be equalled with less cardiotoxic drugs):
Breast Cancer Chemo Hurts Heart? [Time Magazine]
(WASHINGTON) — Breast cancer survivors may face increased risk of heart disease —and doctors are debating if it's time to largely abandon a chemotherapy mainstay that is one reason for the problem.
Drugs called anthracyclines are a breast chemo staple despite a well-known risk: They weaken some women's hearts. What's new is research suggesting the drugs work no better than safer alternatives for most women.
It's a controversy born of success: Treatment advances are enabling more women than ever before to beat breast cancer, and some 2.4 million survivors are alive today. Now a move is under way to determine just how many women are vulnerable to heart disease because of their cancer battle, and how to help them.
Chemo is only one cardiac culprit. Other factors play a role, too: Chest radiation, the weight gain that plagues many survivors, physical inactivity during treatment and stress.
"In the process of curing their breast cancer, we've exposed them to some pretty nasty things. And it's not just one nasty thing, it's a sequence of nasty things," explains Dr. Pamela Douglas, a Duke University cardiologist who is planning research into how to protect these women's hearts.
"This is really coming at you from all sides," says Douglas, who outlined the "multiple hits" in this month's Journal of the American College of Cardiology.
But much of the debate centers on who should use anthracyclines, including the best-known Adriamycin, that can damage heart muscle, sapping its pumping strength.
Dr. Dennis Slamon of UCLA's Jonsson Cancer Center cites nine studies, here and abroad, that conclude that only the 20 percent of patients whose tumors have an overactive gene called Her2 are specifically sensitive to anthracyclines.
Then Slamon's closer inspection found that not all Her2 patients are alike — and only those who have a second overactive gene, called TopoII, derive special benefit from anthracyclines. That's about 8 percent of breast cancer patients.
The powerful Her2-targeting drug Herceptin — key for women with Her2-positive tumors — also comes with a heart-damage warning. But adding it to anthracyclines increases the heart risk fivefold, with no extra benefit, Slamon found.
Outright heart failure during chemo is rare, around 2 percent of patients. But Douglas cites research that anywhere from 10 percent to half of anthracycline users experience more subtle heart weakening, making them more vulnerable to aging's usual rigors, like high blood pressure and cholesterol.
And in this month's Journal of Clinical Oncology, researchers tracked breast cancer survivors ages 66 to 70 who had undergone chemo 10 years earlier. Those who had received an anthracycline were 26 percent more likely to have developed heart failure in the following decade than those on different chemo.
"It's almost like the perfect storm," Slamon says of all the research. "We're adding no incremental benefit with plenty of incremental toxicity."
Now the influential National Breast Cancer Coalition is lobbying oncologists and government regulators to reconsider treatment guidelines.
"These are very strong, very real data that they need to pay attention to," says coalition president Fran Visco.
But many oncologists aren't convinced, and want more evidence that other chemos work as well.

ABSTRACT: Early Breast Cancer Therapy and Cardiovascular Injury [Journal of the American College of Cardiology]
Although recent advances in curative-intent therapies are beginning to produce significant survival gains in early breast cancer, these improvements may ultimately be attenuated by increased risk of long-term cardiovascular mortality. This paper reviews emerging evidence on the cardiovascular effects of breast cancer adjuvant therapy and proposes a new entity that we have labeled the "multiple-hit" hypothesis. The evidence that lifestyle modification, especially exercise therapy, may mitigate these adverse effects is also reviewed. These issues are of considerable practical importance for cardiovascular clinicians, as identification and intervention in those at high risk for cardiovascular complications may reduce a major cause of mortality in women with early breast cancer.

[PinkGirl]

Is it possible that Dr. Slamon meant that there was "no extra benefit" from giving anthracyclines and herceptin AT THE SAME TIME and thus giving a 5X risk of heart damage?

[Jean]

Thanks Lanie for another great article!
It is a shame that many onc's are not up with current
data..or if they are just refuse to consider any change.
This at the exspense of their patient (have to wonder if
it were their wife, daughter, mother) if that would change
the mind a bit? Also a great shame that many dr. still do not
even know about the TOPO testing? As Dr Slamon noted
only 8% have this over active gene. Shame that many
woman are subjected to additional unnecessary risks!

Fighting this disease takes on many battle fields
THANK GOD FOR THIS SITE.
and once again GOD BLESS JOE AND CHRISTINE.

Regards,
Jean

[RhondaH]

here's "basically" the same in LEF

http://www.lef.org/news/LefDailyNews...ection=DISEASE

Rhonda