Breast cancer patients who initially respond to chemotherapy have similar outcomes with further cycles of chemotherapy, while patients who do not initially respond and are treated with further chemotherapy or a different chemotherapy regimen also have similar outcomes, according to two studies published in the April 16 issue of the Journal of the National Cancer Institute.

In the first study, Gunter von Minckwitz, M.D., from Universitats-Frauenklinik Frankfurt and German Breast Group in Neu-Isenburg, Germany, and colleagues randomly assigned 1,390 breast cancer patients who had initially responded to chemotherapy with docetaxel, doxorubicin and cyclophosphamide, to a further four or six cycles of the same chemotherapy for a total of six or eight cycles. The researchers found that the two arms had similar rates of pathological complete response and breast-conserving surgery. The eight-cycle arm had more clinical and sonographic complete responses at surgery but also had more adverse events.

In the second study, the same group of researchers randomly assigned 622 breast cancer patients who did not initially respond to chemotherapy with docetaxel, doxorubicin and cyclophosphamide, to an additional four cycles of the same chemotherapy or four cycles of vinorelbine and capecitabine chemotherapy. The researchers found that the two arms had similar rates of sonographic response, breast-conserving surgery and pathologic complete response. The vinorelbine and capecitabine arm was better tolerated.

"The GeparTrio study is, to our knowledge, the first prospective randomized trial to address this population; however, it was not able to identify a successful improvement in treatment efficacy. New biological agents, preferably those that have a mechanism of action involving the induction of drug sensitivity, should therefore be developed for use in this setting," the authors conclude.

The studies received funding from Amgen, Roche, and Sanofi-Aventis.

Abstract
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Prepared jointly by the editors of RN and HealthDay's Physicians' Briefing (www.physiciansbriefing.com).