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(Ivanhoe Newswire) -- Overall, chemotherapy benefits women with postmenopausal breast cancer, new research suggests, and a new test could help physicians determine who will and won't benefit.
Previous studies have found little or not benefit from adding chemotherapy in postmenopausal patients, and there has been much debate over whether women with tumors fueled by estrogen benefit from receiving chemotherapy drugs in addition to standard anti-hormonal treatments like tamoxifen.
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A study conducted by the Southwest Oncology Group, one of the largest federally funded clinical trial networks, shows chemotherapy generally improves survival in postmenopausal breast cancer patients. In the study, researchers also established the standard of care regarding when to give tamoxifen in relation to chemotherapy; women who took tamoxifen after chemotherapy had better disease-free survival as well as overall survival.
In the study, researchers followed nearly 1,500 postmenopausal women for 10 years. The participants had hormone receptor-positive breast cancer that had spread to at least one lymph node in the armpit area. One group received chemotherapy and tamoxifen, and the other group received tamoxifen therapy alone. The chemotherapy group was 24 percent less likely to see cancer come back.
"With the right chemotherapy regimen, we can favorably impact survival," lead study author Kathy Albain, M.D., of Loyola University Health System, was quoted as saying. "But it also is important to avoid the toxicity and medical costs of chemotherapy when it may not be needed."
A second study highlights a method that may help avoid such unnecessary chemotherapy treatments. Dr. Albain and her team did an analysis to determine whether a certain 21-gene test can predict which women would benefit from chemotherapy. The test examines 21 genes from a tumor sample to determine how active they are, and a score is correlated with benefit to chemotherapy.
Results show there appeared to be no benefit from chemotherapy in women who had a low score on the gene test, while those who scored high did benefit.
Dr. Albain said the test -- which has been performed on 100,000 breast cancer patients since it became commercially available in 2004 -- may be useful in predicting whether chemotherapy could be avoided in a subgroup of patients whose cancer has spread to the lymph nodes.
Source: The Lancet and Lancet Oncology, December 10, 2009
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