Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

’Dose dense’ chemotherapy improves survival in breast cancer patients

12.12.2002


A new clinical trial has shown that reducing the interval between successive doses of a commonly used chemotherapy regimen improves survival in women whose breast cancer has spread to the lymph nodes. While previous research has evaluated the use of various forms of "dose dense" chemotherapy, this is the first major controlled study to show a clear survival benefit for women with node-positive breast cancer. The study was conducted by Cancer and Leukemia Group B (CALGB) for the Breast Cancer Intergroup, a consortium of National Cancer Institute (NCI)-sponsored Cooperative Clinical Trials Groups, and is being presented today at the 25th Annual San Antonio Breast Cancer Symposium.



"This study suggests that many women with breast cancer may benefit from chemotherapy administered on a condensed schedule," said Marc L. Citron, M.D., Albert Einstein College of Medicine, who is the lead investigator of the study. "With the availability of new drugs to control one of the most serious side effects of chemotherapy administration, we can further increase the chances of survival for women with breast cancer." The dose dense regimen was made tolerable for patients because of the drug filgrastim, which helps prevent neutropenia, a serious complication of chemotherapy.

The researchers found that two dose dense regimens provided significantly higher disease-free survival rates than two regimens using conventional dosing, and that efficacy did not differ between the two dose dense regimens. Among patients on the dose dense regimens, disease-free survival was 82 percent after four years, compared to 75 percent for those who received conventional therapy. This difference corresponded to a 26 percent overall reduction in the risk of cancer recurrence. The findings confirm the predictions of a mathematical model developed in the1980s that suggested the value of increased dose density, which was the impetus for the study.


"The improvement in outcome could well represent an important advance in our knowledge of the biology of breast cancer and how best to treat it," said Larry Norton, M.D., of Memorial Sloan-Kettering Cancer Center, senior investigator of the study and one of the developers of the original model. "If confirmed and extended by additional research, this finding could positively affect the care of thousands of patients throughout the world with breast cancer and perhaps, eventually, other diseases."

Researchers tested both dose dense and conventional chemotherapy regimens in 1,973 women with node-positive primary breast cancer and no other metastases. Following surgical removal of their tumors, the women were assigned to one of four treatment regimens involving the standard chemotherapy drugs doxorubicin (A), paclitaxel (T), and cyclophosphamide (C):

- Sequential administration (A followed by T, followed by C) in three-week intervals (conventional)

- Sequential administration in two-week intervals, with filgrastim (dose dense)

- Concurrent administration (A and C together, followed by T) in three-week intervals

- Concurrent administration in two-week intervals, with filgrastim (dose dense)

Since frequent administration of chemotherapy can result in a condition called neutropenia, a decline in the number of a certain type of white blood cells, the researchers administered filgrastim to patients on the dose dense regimens. Also known as the granulocyte-colony stimulating factor (G-CSF), filgrastim helps prevent neutropenia by stimulating the formation of white blood cells called neutrophils. Without it, chemotherapy dosing frequency is limited to longer intervals.

"It is too soon to determine whether a dose dense chemotherapy regimen with filgrastim should be the new standard of care," said Jeffrey Abrams, the oncologist in charge of breast cancer treatment trials at NCI. "However, the reduced risk of cancer recurrence and the low occurrence of side effects are encouraging, and further follow-up as well as other studies testing this approach will hopefully confirm the findings."

In addition to improved disease-free survival, the study indicated that dose dense chemotherapy may also lead to higher overall survival rates. After three years, 92 percent of patients on the dose dense therapy were alive, compared to 90 percent of those on the conventionally administered regimens. This difference corresponded to a 31 percent overall reduction in the risk of death. However, the study authors cautioned that additional follow-up is necessary to confirm this overall survival benefit.

Side effects were found to be no more severe among patients on the dose dense regimens than among those on the conventional treatments, and patients on the dose dense regimens suffered fewer cases of neutropenia. In addition, the study showed that sequential administration produced slightly fewer side effects than the concurrent regimens, with equal efficacy.

Since the mathematical model that led to this study applies to most cancer types and many anti-cancer drugs, the researchers hypothesize that future clinical trials could examine the benefits of dose dense chemotherapy using other drugs and in other types of cancer.

NCI Press Officer | EurekAlert!
Further information:
http://cancer.gov

More articles from Health and Medicine:

nachricht Study suggests possible new target for treating and preventing Alzheimer's
02.12.2016 | Oregon Health & Science University

nachricht The first analysis of Ewing's sarcoma methyloma opens doors to new treatments
01.12.2016 | IDIBELL-Bellvitge Biomedical Research Institute

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Shape matters when light meets atom

Mapping the interaction of a single atom with a single photon may inform design of quantum devices

Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

Im Focus: MADMAX: Max Planck Institute for Physics takes up axion research

The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.

The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...

Im Focus: Molecules change shape when wet

Broadband rotational spectroscopy unravels structural reshaping of isolated molecules in the gas phase to accommodate water

In two recent publications in the Journal of Chemical Physics and in the Journal of Physical Chemistry Letters, researchers around Melanie Schnell from the Max...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

IHP presents the fastest silicon-based transistor in the world

05.12.2016 | Power and Electrical Engineering

InLight study: insights into chemical processes using light

05.12.2016 | Materials Sciences

High-precision magnetic field sensing

05.12.2016 | Power and Electrical Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>