Chemotherapy Treatment Taxol Ineffective In Treating HER-2 Negative Breast Cancer, NEJM Study Says
Main Category: Breast CancerArticle Date: 12 Oct 2007 - 7:00 PST
http://www.medicalnewstoday.com/articles/85301.php
The chemotherapy treatment paclitaxel, sold by
Bristol-Myers Squibb under the brand name Taxol, is ineffective at
treating HER-2 negative breast cancer, the most common form of the
disease, according to a study published Thursday in the New
England Journal of Medicine, the
AP/Google.com reports.
Daniel Hayes of the
University of Michigan and colleagues analyzed a study conducted in
the 1990s that involved more than 3,000 women whose breast cancer had
spread to the lymph nodes but not widely throughout the body (Marchione,
AP/Google.com, 10/10). Half of the participants in the original study
received four courses of the chemotherapy drugs adriamycin and cytoxan,
and half received four courses of the adriamycin-cytoxan combination
along with four courses of Taxol, which is standard protocol among many
oncologists (AFP/Yahoo!
News, 10/10).
The researchers then conducted genetic tests on the original tumor
tissue of 1,322 of the women (Fox,
Reuters, 10/10). Women who had overactive HER-2
positive tumors, about 15% to 20% of all breast cancer patients,
benefited the most from treatment with Taxol, the study found (Ackerman,
Houston Chronicle, 10/11). The study was funded by
NIH and a breast cancer
foundation, and several researchers have ties to BMS (AP/Google.com,
10/10).
Reaction
The researchers did not recommend changes in protocol for breast cancer
treatment and added that further studies are needed to confirm the
finding (Houston Chronicle, 10/11). "We want to make sure
these data are correct before withholding [Taxol] from some patients,"
Hayes said, adding, "On the other hand, we don't want to keep a therapy
that doesn't work." Julie Gralow, a cancer specialist at the University
of Washington
School of Medicine, said that many doctors will be reluctant to
forgo treatment with Taxol until the study's findings are confirmed
because of concern that some patients might file a lawsuit if their
cancer returns and chemotherapy was not offered (AP/Google.com, 10/10).
Don Berry, biostatistics chief at
M.D. Anderson Cancer
Center, said that the "most important question in invasive breast
cancer is who does and doesn't need chemotherapy?" Berry said, "We're
good at adding therapies to a patient's regimen, but not as confident
subtracting them. This study suggests we'll be able to limit therapies
to those who'll truly benefit from them, and other patients can be
spared their side effects without loss of benefit."
Related Editorial
Ann Moore of the
Weill Cornell Medical College in an NEJM
editorial that accompanied the study writes that the
"one-size-fits-all" approach to breast cancer treatment is coming to an
end. "Oncologists have a responsibility to their patients to be aware of
this report," Moore writes (Houston Chronicle, 10/11).
The study is available
online.
NBC's "Nightly
News" on Wednesday reported on the study. The segment includes
comments from Hayes, Dennis Slamon of the
Jonsson
Comprehensive Cancer Center at the University of California-Los
Angeles and a breast cancer patient who took Taxol (Bazell, "Nightly
News," NBC, 10/10). The program on Wednesday also included a discussion
with Susan Love, president and medical director of the
Dr. Susan Love
Research Foundation, about the study and other breast cancer
research (Williams, "Nightly News," NBC, 10/10). Video of the segments
is available
online.
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