The average age of a woman diagnosed with breast cancer is 63, so it is critical to have effective proven, therapies for an older patient population. But older women with breast cancer are underrepresented in clinic trials, so there is little data on the effects of chemotherapy used in addition to other therapies such as surgery.
A new study, published in the May 14 issue of The New England Journal of Medicine, shows that chemotherapy in addition to the surgery or surgery and radiation improves survival among older women.
The study was conducted with 600 women through the Cancer and Leukemia Group B of the National Cancer Institute's Clinical Trials Cooperative Group Program.
"This study is important because it is among the first several trials specifically targeted to older women with early-stage breast cancer and shows that chemotherapy can make a difference," said Hyman Muss, M.D. professor of medicine at the University of North Carolina at Chapel Hill and a member of UNC Lineberger Comprehensive Cancer Center, and corresponding author on the study.
The study compared a combination of chemotherapy drugs – the standard treatment – to a single drug in patients with early-stage breast cancer aged 65 and older. The combination therapy provided significantly better outcomes than a single drug treatment.
Similar studies involving women younger than 70 years of age have also shown that combination therapies provide better outcomes.
For this trial, the standard chemotherapy consisted of either cyclophosphamide, methotrexate, and fluouracil (CMF) or doxorubicin plus cyclophosphamide. The single drug was the oral drug, capecitabine.
Because patients often prefer oral to intravenous chemotherapy, a new effective oral agent for multi-drug treatment would be useful in treating older women with breast cancer. But the study showed that patients who were randomly assigned to capecitabine were twice as likely to have a relapse, and at three-years after completing therapy, the rate of relapse-free survival was 68 percent in the capecitabine group versus 85 percent in the standard-chemotherapy group.
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