This talk was discussed by the advocates who attended SABCS 2007. Anthracyclines have no effect on patients with breast cancer that is HER2-negative, and so these patients could be spared unnecessary toxic effects from this class of agents, concludes a new meta-analysis. The benefits of these agents seem to be confined to women who have HER2 overexpressed or amplified breast tumors, the authors conclude in the January 2 issue of the Journal of the National Cancer Institute. The meta-analysis considered data from 8 published clinical trials and evaluated 5354 patients for whom HER2 information was available. For women with HER2-positive disease (n = 1536 patients), anthracyclines were superior to non–anthracycline-based regimens in disease-free survival and overall survival, the researchers report. The pooled hazard ratio (HR) for the risk for relapse was 0.71 (P < .001), and the HR for the risk for death from any cause was 0.73 (P < .001). However, for women with HER2-negative disease (n = 3818 patients), anthracyclines did not improve either disease-free or overall survival. In this case, the pooled HRs for the risk for relapse was 1.00 (P = .75) and for risk for death, 1.03 (P = .60). "We believe that, based on the available evidence, the use of anthracyclines in the adjuvant treatment of HER2-negative patients is no longer justified," lead researcher Alessandra Gennari, MD, PhD, from the National Cancer Research Institute in Genoa, Italy, told Medscape Oncology. Although anthracycline-containing regimens still represent the standard of care in early breast cancer, there has been some "pulling away" from this class of drugs in the last year or so, Dr. Gennari commented. Results from this meta-analysis, first reported at the San Antonio Breast Cancer Symposium last year, have contributed to this trend, she said, but so have recent results from 2 large US studies, which have shown that regimens not containing anthracyclines are less toxic and are just as effective, if not more so. One of these studies, the Breast Cancer International Research Group 006, was conducted in women with HER2-positive disease, but the other trial, from the US Oncology Group, was conducted in women with breast cancer not selected by HER2 status, notes an accompanying editorial. The editorial suggests that taking into consideration only HER2 status is too simple an approach. Editorialist Soonmyung Paik, MD, and colleagues from the National Surgical Adjuvant Breast and Bowel Project at Allegheny General Hospital in Pittsburgh, Pennsylvania, predict that in the future, "optimization of adjuvant chemotherapy for patients diagnosed with breast cancer will depend on defining the baseline prognosis and chemosensitivity of each subclass of breast cancer beyond those crudely defined by HER2 status alone." "However, from a clinical perspective, anthracycline-containing regimens still represent the standard of care in early breast cancer. Our results summarize the existing data and provide the evidence that is needed to modify treatment guidelines in this setting, with future consequences for tens of thousands of patients worldwide," she told Medscape Oncology. "As a consequence, the clinical importance of our results is not at all historical." The Italian Association for Cancer Research and the University of Genoa, Italy, funded this study. J Natl Cancer Inst. 2008;100:2-4, 14-20. SOURCE: http://www.medscape.com/viewarticle/567978?src=mp Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.