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Old 12-27-2004, 08:17 PM   #1
Merridith
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Study shows surprising benefit of chemotherapy
Source: (cancerfacts.com)
Wednesday, December 15, 2004

SAN ANTONIO – Dec. 15, 2004 – A re-analysis of three large clinical trials for breast cancer shows greatest benefit of chemotherapy occurred in patients without estrogen receptors on tumor surfaces.

Despite the common belief in the oncology community that cancer research and treatment have focused on breast tumors that are estrogen receptor (ER)-positive, a researcher from The University of Texas M. D. Anderson Cancer Center maintains that clinicians have made "enormous strides" in treating patients with tumors that are ER-negative.

In a presentation at the annual meeting of the San Antonio Breast Cancer Symposium last week, Dr. Donald Berry, a professor and chair of the Department of Biostatistics and Applied Mathematics, looked at decades of breast cancer clinical trial experience.

In examining the impact of chemotherapy treatment of patients with breast cancer that had spread to lymph nodes in three national clinical trials, which enrolled more than 6,000 patients cumulatively, Berry found that chemotherapy has reduced the risk of death in ER-negative patients by 56 percent.

"The benefit of chemotherapy advances over the last 20 years to ER-negative patients has been surprisingly dramatic," Berry said in a news release. "The absolute benefit has been similarly impressive, especially in comparison with the corresponding absolute benefit of chemotherapy to ER-positive patients."

The studies, conducted by the Cancer and Leukemia Group B (CALGB) and the U.S. Breast Intergroup, all tested different chemotherapy regimens and doses in women whose cancer had spread to their lymph nodes, and all showed statistically significant results.

In women who are ER-positive, tamoxifen and other selective estrogen receptor modulators (SERMs) have been shown to help prevent cancer development or recurrence. As a result much of the research attention in recent years has focused on the short and long-term survival benefit of tamoxifen therapy and similar newer drugs.

The impact of such preventive treatments, however, was not "weighted" in these trials. Patients were treated with chemotherapy irrespective of hormone sensitivities or whether they had received tamoxifen or not.

Berry says that the results will likely surprise oncologists. "People accept and act as though chemotherapy is equally beneficial independent of ER status," Berry says, "because everyone has assumed that ER status doesn't matter in chemotherapy treatment, but here we show it does."

In his analysis, Berry found that all studies he re-analyzed show that chemotherapy provided a statistically significant benefit for patients with ER-negative tumors, but only a little bit of an effect for ER-positive tumors that had been treated with tamoxifen, and none of the trials showed a statistically significant benefit for higher doses of chemotherapy in ER-positive patients.

Berry hastens to add that this doesn't mean patients with ER-positive tumors should not receive chemotherapy. Instead, he says the study proves that breast cancer patients regardless of ER status are being aided by clinical advances.

"The prevailing wisdom has been that science has focused on ER-positive tumors, with development of SERMs and now aromatase inhibitors, and ER-negative patients have been left in the lurch," Berry says. "Not so. This analysis demonstrates that chemotherapy use has more than doubled survival rates in women with ER-negative tumors."

http://www.cancerfacts.com/Home_News.asp?C...d=4&NewsId=1776
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Old 12-28-2004, 09:13 AM   #2
Janet/FL
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Thanks Merridith, I will take this to my oncologist today along with your other artical. Don't know if it will apply but it looks promising.
Janet/FL
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Old 01-24-2005, 08:12 AM   #3
Tessa
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Dear Meredith,

I just came across your post of this article which seems amazingly relevant (since I think most Her2neu + women tend to be ER -) and extremely heartening, because we ar eused to reading that the Ner2 diagnosis tends to have a gloomier prognosis.

Good news is always welcome,

THANK YOU.

Tessa
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