The prognostic implications of chemotherapy in the treatment of breast cancer

Current Opinion in Obstetrics and Gynecology

Volumn 8, Issue 1, 1996, Pages 21-26

  O'Brien, Mary E R ^a,b,c   Smith, Ian E ^a,b  

^a ROYAL MARSDEN HOSPITAL   (United Kingdom)

^b ROYAL MARSDEN HOSPITAL   (United Kingdom)

^c INSTITUTE OF CANCER RESEARCH   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ANTINEOPLASTIC AGENT; CYCLOPHOSPHAMIDE; DOXORUBICIN; EPIRUBICIN; ESTROGEN RECEPTOR; FLUOROURACIL; METHOTREXATE; PREDNISOLONE; TAMOXIFEN; THIOTEPA; VINCRISTINE;

BREAST CANCER; CANCER ADJUVANT THERAPY; CANCER COMBINATION CHEMOTHERAPY; CANCER RADIOTHERAPY; CANCER SURVIVAL; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; HUMAN; MASTECTOMY; MULTICENTER STUDY; MULTIMODALITY CANCER THERAPY; PRIORITY JOURNAL; PROGNOSIS; RANDOMIZED CONTROLLED TRIAL; REVIEW; SURVIVAL TIME; TREATMENT OUTCOME;

EID: 0029937970     PISSN: 1040872X     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001703-199602000-00006     Document Type: Review

References (28)

1. Sainsbury R, Haward B, Rider L, Johnston C, Round C: Influence of clinician workload and patterns of treatment on survival from breast cancer. Lancet 1995, 345:1265-1270. In this retrospective study of Cancer Registry data from patients with breast cancer, there was considerable variation in survival of breast cancer patients treated by different surgeons. The difference is explained by the rate of usage of chemotherapy and hormone therapy. Patients of surgeons who used chemotherapy had a 4-5% survival benefit at 5 years. The study also showed that those surgeons treating more than 30 new cases of breast cancer per year had better results than those treating fewer.
2. Beral V, Hermon C, Reeves G, Peto R: Sudden fall in breast cancer death rate in England and Wales [Letter]. Lancet 1995, 343:1642-1643.
3. Early Breast Trialists' Collaborative Group: Systemic treatment of early breast cancer by hormonal, cytotoxic or immune therapy. 133 randomised trials involving 31,000 recurrences and 24,000 deaths among 75,000 women. Lancet 1992, 339:1-15, 71-85.
4. Castilglione-Geitsch M, Johsnes C, Goldhirsch A, Gelber RD, Rudenstam CM, Collins J, Lindtner J, Hacking H, Cortes-Funes J, Forbes J, et al. The International (Ludwig) Breast Cancer Study Group Trials I-IV: 15 years follow-up. Ann Oncol 1994, 5:717-724. Four trials in all from this group. Trial 3 shows a positive benefit for both chemotherapy and endocrine therapy compared with endocrine therapy alone or surgery alone in postmenopausal women.
5. Clahsen PC, van de Velde CJH, Welvaart K, Repelare van Driel OJ, Sylvester RJ and cooperating investigators: Ten-year results of a randomized trial evaluating prolonged low-dose adjuvant chemotherapy in node-positive breast cancer: a joint European Organization for Research and Treatment of Cancer-Dutch Breast Cancer Working Party study. J Clin Oncol 1995, 13:33-41. This study with 10-year follow-up comparing two years of low-dose adjuvant chemotherapy with no treatment shows that both pre- and postmenopausal women with one to three positive axillary lymph nodes and ER-negative tumours benefit from this treatment.
6. Bonadonna G, Valagussa P, Moliterni A, Zambetti M, Brambilla C: Adjuvant cyclophosphamide, methotrexate and fluoruracil in node-positive breast cancer - the results of 20 years of follow-up. N Engl J Med 1995, 332:901-906. This study of 386 women with node-positive breast cancer shows the long-term benefits of adjuvant chemotherapy, particularly in the premenopausal group and in those patients with one to three positive axillary lymph nodes.
7. Rivkin SE, Green S, Metch B, Cruz AB, Abeloff MD, Jewell WR, Costanzi JJ, Farrar WB, Minton JP, Osborne CK: Adjuvant CMFVP versus tamoxifen versus concurrent CMFVP and tamoxifen for postmenopausal, node-positive and estrogen receptor-positive breast cancer patients. J Clin Oncol 1994, 12:2078-2085. Postmenopausal ER-positive, node-positive patients were randomly assigned to chemo-endocrine therapy, endocrine therapy or chemotherapy alone. Chemotherapy added no further benefit to tamoxifen in this group.
8. Schumacher M, Basiert G, Bojar H, Hubner K, Olschewski M, Sauerbrei W, Schmoor C, Beyerle C, Neumann RLA, Rauschecker HF for the German Breast Cancer Study Group: Randomized 2 x 2 trial evaluating hormonal treatment and the duration of chemotherapy in node-positive breast cancer patients. J Clin Oncol 1994, 12:2086-2093. This trial of 473 patients with node-positive disease with a follow-up of 56 months shows no difference between RFS and OS in patients receiving either three or six courses of adjuvant CMF.
9. Budd GT, Green S, O'Bryan RM, Martino S, Abeloff MD, Rinehart JJ, Hahn R, Harris J, Tormey D, O'Sullivan J, Osborne CK: Short-course FAC-M versus 1 year of CMFVP in node-positive, hormone-receptor-negative breast cancer: an Intergroup study. J Clin Oncol 1995, 13:831-839. One year of CMFVP is compared with 5 months of CAF plus methotrexate. The two arms were the same for OS but the prolonged treatment gave slightly improved RFS at 5 years (P=0.06).
10. Balslev I, Axelsson CK, Zedeler K, Rasmussen BB, Carstensen B, Mouridsen HT: The Nottingham Prognostic Index applied to 9,149 patients from the studies of the Danish Breast Cancer Cooperative Group (DBCG). Breast Cancer Res Treat 1994, 32:281-290. The Nottingham Prognostic Index was applied to 9149 patients and the authors conclude that patients should be stratified by lymph node status, and that tumour size and histological grade add significant prognostic information, primarily within the group of patients with node-negative disease.
11. Rosselli Del Deltruco M, Palli D, Cariddi A, Ciatto S, Pacini P, Distante V, Azzini V, Belsanti V, Bartolucci R, Diconstanzo F, et al.: Intensive diagnostic follow-up after treatment of primary breast cancer. A randomized trial. National Research Council Project on Breast Cancer follow-up. JAMA 1994, 271:1593-1597. Patients (n = 1243) were randomly assigned to either chest radiography and bone scans in addition to follow-up every 6 months, or follow-up alone. There was an increased detection of isolated intrathoracic and bone metastases in the intensive follow-up group compared with the clinical follow-up group, but there was no difference in 5-year overall mortality. Therefore, routine chest radiograms and bone scans should not be recommended as routine policy.
12. Ghezzi P, Magnanini S, Rinaldini M, Berardi F, Dibiagio G, Testore F, Tavoni N, Schittuli F, Damico C, Pedicini T et al.: Impact of follow-up testing on survival and health-related quality of life in breast cancer patients - a multicenter randomized controlled trial. JAMA 1994, 271:1587-1592. In total, 131 320 women in Italy were randomly assigned either to intensive surveillance or to a control regimen of physician visits and no routine tests. There was no difference in quality of life or overall survival between the two groups at a median follow-up of 71 months.
13. Bonadonna G, Valagussa P, Zucali R, Salvadori B: Primary chemotherapy in surgically resectable breast cancer. CA Cancer J Clin 1995, 45:227-243. A review of primary medical therapy with update of the results of the Milan group at a follow-up of 5 years.
14. Scholl SM, Fourquet A, Asselain B, Pierga JY, Vilcoq JR, Durand JC, Dorval T, Palangie T, Jouve M, Beuzeboc P, et al.: Neoadjuvant versus adjuvant chemotherapy in premenopausal patients with tumours considered too large for breast conserving surgery: preliminary results of a randomised trial: S6. Eur J Cancer 1994, 30A:645-652. Early follow-up of a randomized study of neoadjuvant chemotherapy showing a trend towards improved survival in the neoadjuvant treatment arm.
15. Semiglazov VF, Topuzov EE, Bavli JL, Moiseyenko VM, Ivanova OA, Seleznev IK, Orlov AA, Barash NY, Golubeva OM, Chepic OF: Primary (neoadjuvant) chemotherapy and radiotherapy compared with primary radiotherapy alone in stage IIb-IIIa breast cancer. Ann Oncol 1994, 5:591-595. Similar to [14••], except chemotherapy was a combination of thiotepa, methotrexate and 5-FU, but the results again show a trend towards improved RFS with the neoadjuvant approach.
16. Powles TJ, Hickish TF, Makris A, Ashley SE, O'Brien MER, Tidy VA, Casey S, Nash AG, Sacks N, Cosgrove T, et al.: Randomized trial of chemoendocrine therapy started before or after surgery for treatment of primary breast cancer. J Clin Oncol 1995, 13:547-552. One of the first reported randomized studies of neoadjuvant chemotherapy, involving 200 patients. There was a significant reduction in the mastectomy rate with the use of primary chemotherapy.
17. Sataloff DM, Mason BA, Prestipino AJ, Seinige UL, Lieber CP, Baloch Z: Pathologic response to induction chemotherapy in locally advanced carcinoma of the breast: a determinant of outcome. J Am Coll Surg 1995, 180:297-306. A small series looking at outcome after complete pathological response.
18. Smith IE, Walsh G, Jones A, Prendiville J, Johnston S, Gusterson B, Ramage F, Robertshaw H, Sacks N, Ebbs S, et al.: High complete remission rates with primary neoadjuvant infusional chemotherapy for large early breast cancer. J Clin Oncol 1995, 13:424-429. A very active chemotherapy regimen using infusional 5-FU to achieve a CR rate of 66%.
19. Ayash LJ: High dose chemotherapy with autologous stem cell support for the treatment of metastatic breast cancer. Cancer 1994, 74:532-535. Excellent review on the current use of high-dose chemotherapy in the treatment of breast cancer.
20. Bezwoda WR, Seymour L, Damsey RD: High-dose chemotherapy with hematopoietic rescue as primary treatment for metastatic breast cancer. A randomized trial. J Clin Oncol 1995, 13:2483-2489. The first randomized study of its kind. Positive for high-dose arm. Imbalance in the use of maintenance tamoxifen.
21. Falkson G, Holcroft C, Gelman RS, Tormey DC, Wolter JM, Cummings FJ: Ten-year follow up study of premenopausal women with metastatic breast cancer: an eastern cooperative oncology group study. J Clin Oncol 1995, 13:1453-1458. A group of 347 premenopausal women with ER-positive disease received standard chemotherapy (CAF) at first diagnosis of metastatic breast cancer. The expected median survival was 2.5 years overall and close to 5 years for patients with a good prognosis.
22. McQuellan RP, Muss HB, Hoffman SL, Russell G, Craven B, Yellen SB: Patient preferences for treatment of metastatic breast cancer: a study of women with early-stage breast cancer. J Clin Oncol 1995, 13:858-868. Patients with breast cancer were questioned about what their treatment preference would be should the disease become metastatic. Patients were generally prepared to accept treatment with major toxicity with the chance of a minimal gain.
23. Jones AL, Smith IE, O'Brien MER, Talbot D, Walsh G, Ramage F, Robertshaw H, Ashley S: Phase II study of continuous infusion fluorouracil with epirubicin and cisplatin in patients with metastatic and locally advanced breast cancer: an active new regimen. J Clin Oncol 1994, 12:1259-1265. An infusional regimen with a response rate of 84% but median duration of response of 9 months.
24. Wishart GC, Bissett D, Paul J, Jodrell D, Harnett A, Habeshaw T, Kerr DJ, Macham MA, Soukop M, Leonard RCF, et al.: Quinidine as a resistance modulator of epirubicin in advanced breast cancer: mature results of a placebo-controlled randomized trial. J Clin Oncol 1994, 12:1771-1777. Quinidine does not overcome P-glycoprotein resistance when used with standard chemotherapy in metastatic breast cancer. There was therefore no improvement in response rate or survival using a combination of chemotherapy with quinidine.
25. Wilson WH, Berg SL, Bryant, G, Wittes RE, Bates S, Fojo A, Steinberg SM, Goldspiel BR, Herdt J, O'Shaunessy, et al.: Paclitaxel in doxorubicin-refractory or mitoxantrone-refractory breast cancer: a phase I/II trial of 96-hour infusion. J Clin Oncol 1994, 12:1621-1629. Paclitaxel is active in doxorubicin refractory breast cancer: a 48% partial remission rate was achieved.
26. Chevallier B, Fumoleau, Kerbrat P, Dieras V, Roche H, Krakowski I, Azli N, Bayssas M, Lentz MA, Van Glabbeke M: Docetaxel is a major cytotoxic drug for the treatment of advanced breast cancer: a phase II trial of the clinical screening cooperative group of the European Organization for Research and Treatment of Cancer. J Clin Oncol 1995, 13:314-322. As a single agent, this drug gives a response rate of 68% as first-line treatment of metastatic disease.
27. Ravdin PM, Buuis HA, Cook G, Eisenberg P, Kane M, Bierman WA, Mortimer J, Genevois E, Bellot RE: Phase II trial of docetaxel in advanced anthracycline-resistant or anthracenedione-resistant breast cancer. J Clin Oncol 1995, 13:2879-2685. One of a number of studies showing high response rate with taxotere.
28. Porkka K, Blomqvist C, Rissanen P, Elomaa I, Pyrhonen S: Salvage therapies in women who fail to respond to first-line treatment with fluorouracil, epirubicin, and cyclophosphamide for advanced breast cancer. J Clin Oncol 1994, 12:1639-1647. Response rates to salvage therapies are on average about 10% and occur during the first salvage therapy.