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SAN ANTONIO -- Many women with lymph node--positive breast cancer are likely to receive chemotherapy on a novel compressed schedule as a result of a major clinical trial showing that this markedly improves outcomes.
Moreover, this successful clinical confirmation of the superiority of dense dosing, as it is called, may have major implications for chemotherapy in numerous other cancers, including gynecologic malignancies. Dense dosing may also have applications in a broad range of noncancerous diseases, although each potential new application will need to be studied in turn, Dr. Marc L. Citron said at a breast cancer symposium sponsored by the San Antonio Cancer Institute.
Dense dosing boosted disease-free survival by 26%, compared with conventional adjunctive chemotherapy schedules in a National Cancer Institute--sponsored randomized trial involving 1,973 surgically treated nodepositive breast cancer patients with no other metastases. Disease-free survival--the primary study end point--was 82% at 4 years in dense-dosed patients, compared with 75% for those who got identical cumulative doses of doxorubicin, paclitaxel, and cyclophosphamide on a conventional schedule.
Overall survival after 3 years was 92% in patients who received dense-dose chemotherapy, compared with 90% in those on conventional chemotherapeutic regimens. This translates into an adjusted 31% reduction in the relative risk of mortality, although longer follow-up will be needed to be sure of the true size of this effect, said Dr. Citron, lead investigator in the trial and an oncologist at Albert Einstein College of Medicine in New York.
A further advantage of dense-dose chemotherapy is that it shortens the duration of a complete course of chemotherapy from 24 to 16 weeks, enabling patients to bid an earlier goodbye to the nausea, vomiting, and other chemotherapy-related unpleasantness and get on with their lives.
Dense dosing involves administration of standard doses of ...
Source: HighBeam Research, Breast cancer patients often fare better with dense-dose chemotherapy...