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 Penn vet research identifies new target for taming Ebola
12.01.2017 | University of Pennsylvania

nachricht The strange double life of Dab2
10.01.2017 | University of Miami Miller School of Medicine

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: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

Im Focus: How to inflate a hardened concrete shell with a weight of 80 t

At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).

Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...

Im Focus: Bacterial Pac Man molecule snaps at sugar

Many pathogens use certain sugar compounds from their host to help conceal themselves against the immune system. Scientists at the University of Bonn have now, in cooperation with researchers at the University of York in the United Kingdom, analyzed the dynamics of a bacterial molecule that is involved in this process. They demonstrate that the protein grabs onto the sugar molecule with a Pac Man-like chewing motion and holds it until it can be used. Their results could help design therapeutics that could make the protein poorer at grabbing and holding and hence compromise the pathogen in the host. The study has now been published in “Biophysical Journal”.

The cells of the mouth, nose and intestinal mucosa produce large quantities of a chemical called sialic acid. Many bacteria possess a special transport system...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

Nothing will happen without batteries making it happen!

05.01.2017 | Event News

 
Latest News

Water - as the underlying driver of the Earth’s carbon cycle

17.01.2017 | Earth Sciences

Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

17.01.2017 | Materials Sciences

Smart homes will “LISTEN” to your voice

17.01.2017 | Architecture and Construction

VideoLinks
B2B-VideoLinks
More VideoLinks >>>