Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study supports tailoring adjuvant therapy for early-stage breast cancer

17.12.2003


Premenopausal women with lymph node-negative breast cancer should receive adjuvant therapy tailored according to the estrogen receptor status of the primary tumor, concludes a study by the International Breast Cancer Study Group (IBCSG) reported in the December 17 issue of the Journal of the National Cancer Institute.



Patients with estrogen receptor (ER)-negative (i.e., endocrine nonresponsive) breast cancer should receive adjuvant chemotherapy, according to the study, whereas for patients with ER-positive (i.e., endocrine responsive) tumors, the use of endocrine therapy alone or in combination with adjuvant chemotherapy requires further study.

Some studies have suggested that cytotoxic chemotherapy benefits premenopausal women with breast cancer because it causes premature menopause. The new study addresses whether adjuvant ovarian function suppression can be used as a replacement for or as a supplement to cytotoxic adjuvant chemotherapy for premenopausal women with early-stage breast cancer.


These findings support the idea that ovarian suppression "is a viable treatment alternative for at least some premenopausal women with breast cancer," comment Joseph L. Pater, M.D., and Wendy R. Parulekar, M.D., of the National Cancer Institute of Canada Clinical Trials Group at Queen’s University in Kingston, Ontario, in an accompanying editorial.

In the study, Monica Castiglione-Gertsch, M.D., and her colleagues from the IBCSG, compared outcomes of 1,063 pre- and perimenopausal women who were previously treated for lymph-node negative (early-stage) breast cancer and randomly assigned to receive adjuvant chemotherapy, adjuvant therapy with the ovarian function suppression drug goserelin, or adjuvant chemotherapy followed by goserelin. The women were tested to determine the estrogen receptor status of their tumors.

After a median follow-up of 7 years, there was no difference in disease-free survival or overall survival among patients in the three treatment groups. However, a subgroup analysis revealed that patients with ER-negative tumors who received chemotherapy alone or followed by goserelin had better disease-free survival than patients who received goserelin alone. By contrast, among patients with ER-positive tumors, results were similar after chemotherapy alone or goserelin alone. Sequential use of chemotherapy followed by goserelin resulted in a statistically nonsignificant benefit that was limited to younger women.

The authors caution that their findings "should not alter current patient care, but rather emphasize the relevance of current studies of chemotherapy and endocrine agents." The editorialists agree, recommending that future studies examine the selective use of ovarian suppression in women who are not rendered menopausal by chemotherapy.


Contact: Monica Castiglione-Gertsch, M.D., International Breast Cancer Study Group, 41-31-389-9191; fax: 41-31-389-9200, monica.castiglione@siak.ch.

To interview coauthor Richard Gelber, contact Janet Haley-Dubow, Dana-Farber Cancer Institute, 617-632-5665, janet_haley@dfci.harvard.edu.

Editorial: Nancy Dorrance, Queen’s University, 613-533-2869, dorrance@post.queensu.ca.
International Breast Cancer Study Group. Adjuvant chemotherapy followed by goserelin versus either modality alone for premenopausal lymph node–negative breast cancer: A randomized trial. J Natl Cancer Inst 2003;95:1833–46.

Editorial: Pater JL, Parulekar WR. Ovarian ablation as adjuvant therapy for premenopausal women with breast cancer--another step forward. J Natl Cancer Inst 2003;95:1811–2.

Note: The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage. Visit the Journal online at http://jncicancerspectrum.oupjournals.org/.

Katherine Arnold | EurekAlert!
Further information:
http://jncicancerspectrum.oupjournals.org

More articles from Health and Medicine:

nachricht Correct connections are crucial
26.06.2017 | Charité - Universitätsmedizin Berlin

nachricht One gene closer to regenerative therapy for muscular disorders
01.06.2017 | Cincinnati Children's Hospital Medical Center

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: Can we see monkeys from space? Emerging technologies to map biodiversity

An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.

Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...

Im Focus: Climate satellite: Tracking methane with robust laser technology

Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.

Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...

Im Focus: How protons move through a fuel cell

Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.

As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...

Im Focus: A unique data centre for cosmological simulations

Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.

With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...

Im Focus: Scientists develop molecular thermometer for contactless measurement using infrared light

Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine

Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Plants are networkers

19.06.2017 | Event News

Digital Survival Training for Executives

13.06.2017 | Event News

Global Learning Council Summit 2017

13.06.2017 | Event News

 
Latest News

Study shines light on brain cells that coordinate movement

26.06.2017 | Life Sciences

Smooth propagation of spin waves using gold

26.06.2017 | Physics and Astronomy

Switchable DNA mini-machines store information

26.06.2017 | Information Technology

VideoLinks
B2B-VideoLinks
More VideoLinks >>>