The Pharmaceutical Journal
Vol 269 No 7222 p632
2 November 2002

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European Society for Medical Oncology congress (more)

High-dose chemotherapy for breast cancer no better than normal

There is no difference in survival or relapse rate among breast cancer patients receiving high-dose and conventional chemotherapy, according to the early results of a trial comparing two regimens.

The Anglo-Celtic I study, which has recruited over 600 women with breast cancer involving the lymph nodes, has recorded 120 cancer relapses in each arm of the trial and five treatment-related deaths, all in the high-dose chemotherapy treatment arm, after an average follow-up of five years. Meanwhile, cancer deaths in the two treatment groups are comparable — 86 among the high-dose group and 84 among those receiving conventionally dosed adjuvant chemotherapy.

Study leader Dr John Crown, of St Vincent's University Hospital in Dublin, said: "In truth, the results of conventional-dose chemotherapy were better than expected. However, we must keep an open mind for the rest of the data, although our results already indicate that any benefits that emerge from high-dose chemotherapy will be, at best, modest. I believe that these results show us how far we can go with chemotherapy."

The data were presented at the European Society for Medical Oncology congress, which was held in Nice, last month.

The meeting also heard that adding oxaliplatin (Eloxatin) to 5-fluoro-uracil (5-FU) and calcium folinate, can delay tumour progression in patients with colorectal cancer by 70 per cent.

Interim results for 463 patients taking part in a phase III trial to compare these two treatment regimens show that the mean time to tumour progression was 4.6 months in patients treated with all three drugs compared with 2.7 months for those given 5-fluorouracil and calcium folinate alone (P<0.0001).

Speaking at the meeting, Dr Mace Rothenberg, from the Vanderbilt-Ingram Cancer Centre, Nashville, and one of the study investigators, said: "Both the delay in time to progression and the reduction in tumour-related symptoms are encouraging." He added that patients suffered less from pain, weight loss and fatigue with combination therapy.

Final data from the trial are expected in about six months.

"At that point, we will know more about the impact of the oxaliplatin, 5-FU and [clacium folinate] combination on the survival of patients with recurrent colorectal cancer," said Dr Rothenberg.