A new head-to-head study has found that the chemotherapy drug docetaxel (taxis more effective than vinorelbine (Navelbine) in helping extend patient survival after breast cancer surgery. The Finnish study also found that patients who received infusions of trastuzumah & (Herceptin) were less likely to get recurrences than those who received a placebo.
For this study, Dr. Heikki Joensuu, a physician at Helsinki University Central Hospital, and his colleagues randomly assigned more than 1,000 women who had breast cancer to receive three cycles of either docetaxel or vinorelbine, followed by three cycles of other cancer drugs. They wanted to determine which regimen was best for recurrence-free survival.
"There were 42% fewer breast cancer recurrences during the first three years of follow-up among women treated with docetaxel as compared to those who received vinorelbine," says Joensuu. However, docetaxel was associated with more adverse side effects, such as allergic reactions, swelling and fever.
In another part of the study, a subgroup of 232 women who had more aggressive cancers were assigned either to receive nine weeks of Herceptin infusions or a placebo.
The women who got Herceptin experienced 58% fewer cancer recurrences during the three-year follow-up than those who did not get the drug, the researchers report.
Finding The Optimal Duration
According to Joensuu, this study supports previous research. 'A few prior studies have shown that administration of adjuvant [Herceptin] for one year reduces the rate of breast cancer recurrence by approximately 500/0" in women who have aggressive cancers, he says.
However, in this study the Herceptin was administered for only nine weeks, which could explain why it was not linked to an increased risk of cardiac failure, as it was in previous research.
"'We don't know the optimal duration of [Herceptin]-is nine weeks as good as one year," asks Dr. Mark Pegram, director of the women's cancer program at the Jonsson Comprehensive Cancer Center part of the David Geffen School of Medicine at the University of California at Los Angeles.
If the nine-week regimen turns out to be ideal, Pegram says, "it could be very good news for patients," sparing them time and much expense.
Death rates from breast cancer have decreased in recent years, partly because of postoperative chemotherapy. Experts are continually testing new regimens to determine which drugs best reduce the risk of recurrence.