Repeat Use of Anthracyclines May Not Be Warranted in Breast Cancer

Repeat Use of Anthracyclines May Not Be Warranted in Breast Cancer

According to an article recently published in the British Journal of Cancer, repeat administration of anthracyclines does not appear to provide benefit in women with breast cancer whose disease has progressed following prior treatment with anthracyclines.

Anthracyclines are a class of chemotherapy agents that provide significant anticancer activity in the treatment of breast cancer. Some patients, however, develop disease progression following initial treatment with anthracyclines; they may be re-treated with the agent in hopes of a subsequent anticancer response. A drawback of this approach is that larger, cumulative doses of anthracyclines are implicated in increased risk of heart complications. As well, it is not known how well these patients will respond to re-treatment with the agents.

Researchers from Italy recently conducted a small clinical trial to evaluate the effectiveness of re-treatment with the anthracycline Ellence® (epirubicin) in women with breast cancer.

This trial included 51 women with metastatic breast cancer (cancer that has spread to distant sites in the body) who had received prior therapy with Ellence for earlier disease; their cancer had progressed despite this prior therapy. Approximately half of the patients were re-treated with Ellence in addition to Taxotere® (docetaxel), while the other half received Taxotere alone.

  • Patients treated with Taxotere alone had equivalent or superior outcomes to those treated with Ellence/Taxotere.
  • Complete disappearances of detectable cancer occurred in 16% of patients treated with Ellence/Taxotere compared with 25% of patients treated with Taxotere alone.
  • Partial disappearance of cancer occurred in 56% of patients treated with Ellence/Taxotere compared with 54% of patients treated with Taxotere alone.
  • Disease stabilization was achieved in 16% of patients treated with Ellence/Taxotere compared to 12% of patients treated with Taxotere alone.
  • Time to cancer progression was nine months for those treated with Ellence/Taxotere compared to 11 months for those treated with Taxotere alone.
  • Median survival was 18 months for patients treated with Ellence/Taxotere compared with 21 months for those treated with Taxotere alone.
  • Patients treated with Ellence/Taxotere suffered more side effects than those treated with Taxotere alone.

The researchers concluded that repeat administration of anthracyclines is not warranted in patients with breast cancer whose disease has progressed following prior treatment including an anthracycline; agents such as Taxotere used alone provide similar outcomes without the associated side effects.

Reference: Pacillo C, Morabito A, Nuzzo F, et al. Is Epirubicin Effective in First-Line Chemotherapy of Metastatic Breast Cancer (MBC) After an Epirubicin-Containing Adjuvant Treatment? A Single Centre Phase III Trial. British Journal of Cancer. 2006;94: 94, 1233-1236.

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