The Royal Melbourne Hospital (Tel: 03 9342 7000)
Amgen Australia Pty Ltd
Medical Information Toll Free: 1800 803 638 www.amgen.com.au
Wednesday May 21, 2003
For immediate release:
Faster chemotherapy treatment improves breast cancer survival1
Australian breast cancer specialists are considering a new way of using existing chemotherapy agents to treat advanced breast cancer in women after a recent US study demonstrated improved survival outcomes.
In Australia, over 10,500 women develop breast cancer every year and a quarter of these women die. At present, chemotherapy is used after surgery and radiotherapy and often alongside hormone treatment, when there is a high risk of tumour regrowth or a risk of secondary tumours developing.
The American study* investigated 2,005 women and showed that giving existing chemotherapy agents over a shorter time period reduced the rate of breast cancer recurrence by 26 per cent and the rate of death by 31 per cent during the study period.
In this trial, women received the same doses of chemotherapy - four doses each of doxorubicin (A), paclitaxel (T) and cyclophosphamide (C). The only difference was that half the women received their therapy in two weekly intervals (called dose-dense) while the other half received their chemotherapy using the historically standard three-week interval. The study found that those women who received their chemotherapy more often, over the shorter, two-weekly time frame, suffered fewer cancer relapses and there were fewer deaths.
According to Associate Professor Michael Green, Deputy Director of Clinical Haematology and Oncology at the Royal Melbourne Hospital, “dose-dense therapy ensures and maintains the optimum dose of chemotherapy so that the cancer cells do not have a chance to regrow. It’s all about hitting them hard and hitting them fast. Dose-dense therapy uses the same chemotherapy agents we use now but uses them in a different way,” he says.
A potentially serious side effect of cancer treatment and chemotherapy is a condition called neutropenia, where the body’s production of infection-fighting white blood cells is reduced, which can lead to a life-threatening infection, hospitalisation and delays in chemotherapy treatment.
To counter this potential side effect, all the women receiving dose-dense therapy in the American trial also received daily injections of a white blood cell growth factor, which protects against infection and the toxicities of chemotherapy.
Dr Green who has been involved for many years in international trials
of blood growth factors explains, “in order to maintain these doses
of chemotherapy we need the aid of white blood
cell growth factor agents.
“In the past, we separated the application of the different chemotherapy drugs over a longer period of time, to give the body’s white blood cell level time to recover. This new information indicates we can use a combination of chemotherapy agents over very short periods of time and by accelerating the frequency of our existing agents we hope to improve the effectiveness of breast cancer chemotherapy.”
Dr Clifford Hudis, who is Chief of the Breast Cancer Medicine Service at Memorial Sloan-Kettering Cancer Center in New York and one of the investigators in the landmark dose-dense study, agrees: “We’ve shown the administration of dose-dense therapy achieves better outcomes with less toxicity using shorter treatment time in a large trial where every patient received the same dose of chemotherapy drugs.
"The only difference between the two groups of women in our trial was the time interval of chemotherapy and the support of the white blood cell growth factor for the women receiving dose-dense chemotherapy."
"Dose dense chemotherapy regimens are shorter, measurably less toxic because they are combined with growth factors and carry a lower risk of hospitalisation, which together delivers economic as well as health and safety benefits. This means patients can get back to work and get on with their lives sooner,” Dr Hudis says.
Dr Michael Green and Dr Clifford Hudis are both available for interview
* * *
Released by:
Roland Hughes
Roland Hughes Public Relations (02) 9954 1927 or 0419 218 871
Rod Jackson-Smith
Corporate Affairs, Melbourne Health
(Royal Melbourne Hospital is part of Melbourne Health) (03) 9342 7469
or 0417 156 214
* Coordinated by the Cancer and Leukemia Group B; an NCI-funded cooperative group.
Dr Hudis is visiting Australia to talk to oncologists about dose-dense chemotherapy treatment for women with breast cancer.
References: Citron ML et al. Randomised trial of dose-dense versus conventionally scheduled and sequential versus concurrent combination chemotherapy as postoperative adjuvant treatment of node-positive primary breast cancer: First report of Intergroup Trial CALGB 9741. J Clin Oncol 2003; 21:1431-1439.
Pharmaceutical Benefits Scheme (PBS) Information: Refer to PBS Schedule for full benefit information doxorubicin (A): This product is listed on the PBS as a chemotherapeutic agent. paclitaxel (T): Restricted benefit, authority required. Refer to PBS schedule for full restricted benefit information. cyclophosphamide (C) : This product is listed
on the PBS as a chemotherapeutic agent. |
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