According to a recent study, the currently used chemotherapy regimens have reduced deaths due to breast cancer by approximately one-third compared to no chemotherapy.
A number of chemotherapy combinations have been used in the treatment of breast cancer. But is there any regimen that may be better than the rest? An analysis of more than 100 trials to compare the use of different types of chemotherapy in early breast cancer was carried out. The chemotherapy regimens studied were
Advertisement• taxane-based versus non-taxane-based regimens
• anthracycline-based regimen versus standard or near-standard cyclophosphamide, methotrexate, and fluorouracil (CMF) regimen
• higher versus lower anthracycline dosage
• polychemotherapy versus no adjuvant chemotherapy
The analysis found the following:
• The older chemotherapy regimens reduced breast cancer deaths by about a quarter, the best being standard CMF and standard 4AC regimens. With these regimens, 2-year recurrence rates were halved and cancer recurrence rates during the next 8 years were reduced by one-third. Regimens using lower doses per cycle were less effective.
• Regimens with substantially more chemotherapy than standard 4AC were more effective. These included regimens such as CAF11, 15 or CEF19. These reduced deaths due to cancer by a further one-sixth.
• Chemotherapy reduced deaths due to cancer in all groups over a period of 10 years by about a third as compared to no chemotherapy. The reduction in deaths was irrespective of age, status of lymph nodes, tumor diameter, tumor differentiation or presence of estrogen receptors on the tumor.
• Deaths in ER-positive breast cancers are very much reduced when chemotherapy is combined with endocrine treatment rather than administration of endocrine treatment alone.
Chemotherapy may thus be beneficial in a number of women with early breast cancer as adjuvant treatment.
1. Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100 000 women in 123 randomised trials; Breast cancer trials group; The Lancet, Volume 379, Issue 9814, Pages 432 - 444; Feb 2012.
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