Q: I completed breast cancer treatment last year with a combined chemotherapy regimen that included 5-FU, doxorubicin, and cyclophosphomide. I’ve just read that there is a new combined regimen that’s now considered more effective. Can you tell me more?
Answer from the expert staff of breast cancer research at the Robert W. Franz Cancer Research Center at Providence Portland Medical Center: Study results presented at the 2003 San Antonio Breast Cancer Symposium do indicate that a new chemotherapy regimen may offer improved outcomes in women with early-stage, node-positive breast cancer compared with the regimen you received.
The Breast Cancer International Research Group (BCIRG) conducted the study, called BCIRG 001. Researchers enrolled 1,491 premenopausal and postmenopausal women with breast cancer that had spread to their lymph nodes, including women with estrogen receptor-positive and estrogen receptor-negative tumors. Half of the participants were treated with the adjuvant chemotherapy regimen that’s been considered a standard: 5 fluorouracil (5-FU), doxorubicin (Adriamycin), and cyclophosphomide (Cytoxan), a combination known as FAC. The other half were treated with a new regimen, known as TAC, that combines docetaxel (Taxotere) with doxorubicin and cyclophosphomide. Both groups received the chemotherapy once every three weeks for a total of six times.
Study results after five years of follow-up showed significantly better outcomes for the TAC recipients. Women who were treated with TAC had a disease-free survival rate of 75 percent, compared with 68 percent in those receiving FAC. The overall survival rate was 87 percent for women on TAC versus 81 percent for women on FAC.
These data represent a 28 percent reduction in the relative risk of recurrence and a 30 percent reduction in the relative risk of mortality for those on TAC compared to those on FAC.
Significantly, TAC was found to be more effective than FAC for both estrogen receptor-positive and estrogen receptor-negative participants. The TAC regimen reduced the risk of recurrence in these two groups by 27 percent and 34 percent, respectively.
The only group that did not show significantly better outcomes on TAC compared to FAC was women with four or more positive lymph nodes. Among these participants, there was a trend toward superior results with TAC vs. FAC, but it did not reach statistical significance.
The BCIRG 001 study data suggest that the TAC regimen can help early-stage breast cancer patients with one to three positive lymph nodes prevent recurrence and live longer than they would if they were treated with FAC. If you’re currently deciding on adjuvant chemotherapy treatment options, be sure to discuss with your doctor whether TAC might the best choice for you.
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December 2003
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