In a study published in the New England Journal of Medicine, doctors have announced that the addition of the chemotherapy drug epirubicin to standard chemotherapy can help more women to survive early breast cancer.
Chemotherapy is given after surgery to patients suffering from breast cancer to destroy any molecules of cancer that might have spread to other parts of the body. The standard chemotherapy treatment involves a combination of three drugs and is known as CMF (a cocktail of clophosphamide, methotrexate and fluorouracil). In the study, doctors have announced that a chemotherapy “super-cocktail” given to women with breast cancer reduced deaths by more than 30 per cent, compared with standard treatment. This news comes from two British studies that together looked at 2,400 patients with early breast cancer. Both studies show better survival rates with epirubicin in addition to standard chemotherapy.
In the study, half of the patients were treated with the standard chemotherapy while the other half were given the drug epirubicin along with the standard chemotherapy.
The researchers found that in group of patients treated with epirubicin plus chemotherapy, 82 percent lived for at least 5 years and 76 percent did not have relapses. Whereas in the patients treated only with the standard chemotherapy, only 75 percent lived for at least five years and only 69 percent did not have relapses.
Chris Poole, the consultant medical oncologist at the University of Birmingham, said: “The results show conclusively that the addition of epirubicin to chemotherapy has a significant impact on survival in early stage breast cancer.”
Dr Poole said that most women with breast cancer in the UK would be treated with epirubicin. “But whether they are getting it in the right dose and on the right schedule is another matter,” he said.
High doses of epirubicin were administered for the first four cycles of treatment but it was then replaced with standard chemotherapy, maximizing the impact of the drug but minimizing the long-term risks, such as leukemia.
The women were recruited to the study between 1996 and 2001 to look at the recurrence of tumors and survival rates. Unlike the hormonal treatment Herceptin, which is effective in only 20 per cent of patients with oestrogen-positive breast cancer, chemotherapy works for all women?
“It is an old-fashioned, blunderbuss treatment. It does seem to be uniformly effective,” Dr Poole said.
The evidence showed that the effects of hormonal drugs such as Herceptin given after chemotherapy had a cumulative effect, on top of any survival gain achieved by the chemotherapy, Dr Poole said.
The researchers maintain that further studies need to be conducted before the doctors are able to determine the best chemotherapy regimen for an individual patients caner treatment.
The results of the studies, funded by Cancer Research UK and others are published today in the New England Journal of Medicine.