Postsurgery chemotherapy questioned for certain patients.

2002 AUG 15 - (NewsRx.com & NewsRx.net) -- Postmenopausal breast cancer patients with estrogen-sensitive tumors who undergo chemotherapy following surgery to increase their survival odds may not benefit from the regimen, which is often prescribed along with the hormone-blocking drug tamoxifen, according to an international study.

The research did show, however, that patients whose tumors were unresponsive to estrogen (known as ER-negative tumors) gained a decided benefit from chemotherapy. These patients were significantly less likely to relapse and less likely to die 5 years after treatment than those who didn't receive chemotherapy.

Published in the July 17, 2002, Journal of the National Cancer Institute, the findings question the value of the chemotherapy treatment following breast surgery in postmenopausal women who have relatively early tumors that haven't spread to their lymph nodes (node-negative), and which are responsive to the hormone estrogen (ER-positive).

The results, said Richard Gelber, PhD, a biostatistician at the Dana-Farber Cancer Institute who headed the statistical analysis of the trial data, indicate that cancer treatments need to be more finely "tailored" to the characteristics of patients and their tumors, in order to avoid unnecessary discomfort and expense.

"I'm hoping it will cause physicians and research investigators to examine more carefully whether or not these postmenopausal women with node-negative, ER-positive diseases should routinely be offered chemotherapy," Gelber said.

A total of 1669 patients from many countries were recruited into the trial. All were postmenopausal and had node-negative cancer. About 75% had ER-positive tumors and 23% had tumors that were ER-negative: a small fraction were undetermined.

The women were randomly assigned to receive either chemotherapy followed by tamoxifen, or tamoxifen alone for 5 years.