Women's Health Policy Report Highlights Studies From Recent Breast Cancer Conference

The following summarizes findings reported last week at the San Antonio Breast Cancer Symposium.

~ Anthracyclines: New research suggests that anthracyclines -- a class of chemotherapy drugs commonly used to treat breast cancer -- could cause more harm than benefits for breast cancer patients because they can be damaging to the heart, the Wall Street Journal reports. Researchers from the Breast Cancer International Research Group studied the effects of two courses of breast cancer treatment: anthracyclines taken in conjunction with Herceptin -- which is used to treat women who have HER-2-positive cancer -- and Herceptin taken with non-anthracycline drugs. A third control group was treated with just anthracyclines, such as doxorubicin and epirubicin. At the symposium, researchers presented data from the five years of the 10-year study showing that women in both Herceptin groups were more likely to remain alive after five years than women in the control group. There was no significant difference in mortality between the two Herceptin groups, but the study did detect significantly higher levels of heart damage, including congestive heart failure, for women in the Herceptin plus anthracycline group. That group also experienced higher leukemia rates, a secondary consequence of the chemotherapy treatment. According to the Journal, the results "renewed a debate over whether ... anthracyclines, which have been around since the 1960s, should remain the standard of care in treating breast cancer, or whether newer drugs should be used more frequently" (Wang, Wall Street Journal, 12/14).

~ Bone drugs: Women who take oral bisphosphonates to prevent bone loss developed about one-third fewer breast cancers than other women, according to two new observational studies, the New York Times reports. The research comes from a retrospective analysis of data from the Women's Health Initiative and a separate Israeli observational study of several thousand postmenopausal women. The WHI, a federal study, included 151,592 postmenopausal women who were followed for an average of 7.8 years, with 2,216 of the women taking oral bisphosphonates at the start of the study. There were 3.29 cancers per 1,000 women taking the bone-loss drugs over the course of one year, compared with 4.38 cancers per 1,000 women not taking the medications. The analysis found that there were 32% fewer new breast cancers among users of the bone-loss drugs after researchers adjusted for various risk factors among women from both groups, according to the Times. The Israeli study included 4,575 postmenopausal women and found that women who used the drugs for more than one year had a 29% relative reduction in risk for breast cancer. The study also found that breast cancer tumors developing among the bone-loss drug users were more likely to be estrogen receptor-positive, the Times reports (Rabin, New York Times, 12/11). Although the results "provide the best evidence to date" of the drugs' efficacy at reducing breast cancer risk, it is still too early for women to use the drugs for the purpose of preventing cancer, according to Gad Rennert, the lead investigator of the Israeli study and director of the National Israeli Cancer Control Center (Wang, Wall Street Journal, 12/11).














~ Tykerb: In a second trial involving Herceptin, researchers found that women who were treated with a combination of Herceptin and a second treatment, Tykerb, lived nearly five months longer than women treated with Tykerb alone, the AP/Philadelphia Inquirer reports. The study targeted women with very advanced breast cancer for whom other treatments are no longer effective. Doctors said they hope benefits of the combined treatments will be more pronounced for women with less-advanced breast cancer. Herceptin and Tykerb are both designed to treat HER-2-positive breast cancer, albeit in different ways (Marchione, AP/Philadelphia Inquirer, 12/11). The findings could help lessen doctors' reliance on chemotherapy in favor of more targeted treatments, according to lead researcher Kimberly Blackwell of Duke University (Wang, "Health Blog," Wall Street Journal, 12/11).


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View drug information on Herceptin; Tykerb.