Chemotherapy Treatment Taxol Ineffective In Treating HER-2 Negative Breast Cancer, NEJM Study Says

Main Category: Breast Cancer
Article Date: 12 Oct 2007 - 7:00 PDT

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The chemotherapy treatment paclitaxel, sold by Bristol-Myers Squibb under the brand name Taxol, is ineffective at treating HER-2 negative breast cancer, the most common form of the disease, according to a study published Thursday in the New England Journal of Medicine, the AP/Google.com reports.

Daniel Hayes of the University of Michigan and colleagues analyzed a study conducted in the 1990s that involved more than 3,000 women whose breast cancer had spread to the lymph nodes but not widely throughout the body (Marchione, AP/Google.com, 10/10). Half of the participants in the original study received four courses of the chemotherapy drugs adriamycin and cytoxan, and half received four courses of the adriamycin-cytoxan combination along with four courses of Taxol, which is standard protocol among many oncologists (AFP/Yahoo! News, 10/10).

The researchers then conducted genetic tests on the original tumor tissue of 1,322 of the women (Fox, Reuters, 10/10). Women who had overactive HER-2 positive tumors, about 15% to 20% of all breast cancer patients, benefited the most from treatment with Taxol, the study found (Ackerman, Houston Chronicle, 10/11). The study was funded by NIH and a breast cancer foundation, and several researchers have ties to BMS (AP/Google.com, 10/10).

Reaction
The researchers did not recommend changes in protocol for breast cancer treatment and added that further studies are needed to confirm the finding (Houston Chronicle, 10/11). "We want to make sure these data are correct before withholding [Taxol] from some patients," Hayes said, adding, "On the other hand, we don't want to keep a therapy that doesn't work." Julie Gralow, a cancer specialist at the University of Washington School of Medicine, said that many doctors will be reluctant to forgo treatment with Taxol until the study's findings are confirmed because of concern that some patients might file a lawsuit if their cancer returns and chemotherapy was not offered (AP/Google.com, 10/10).

Don Berry, biostatistics chief at M.D. Anderson Cancer Center, said that the "most important question in invasive breast cancer is who does and doesn't need chemotherapy?" Berry said, "We're good at adding therapies to a patient's regimen, but not as confident subtracting them. This study suggests we'll be able to limit therapies to those who'll truly benefit from them, and other patients can be spared their side effects without loss of benefit."

Related Editorial
Ann Moore of the Weill Cornell Medical College in an NEJM editorial that accompanied the study writes that the "one-size-fits-all" approach to breast cancer treatment is coming to an end. "Oncologists have a responsibility to their patients to be aware of this report," Moore writes (Houston Chronicle, 10/11).

The study is available online.

NBC's "Nightly News" on Wednesday reported on the study. The segment includes comments from Hayes, Dennis Slamon of the Jonsson Comprehensive Cancer Center at the University of California-Los Angeles and a breast cancer patient who took Taxol (Bazell, "Nightly News," NBC, 10/10). The program on Wednesday also included a discussion with Susan Love, president and medical director of the Dr. Susan Love Research Foundation, about the study and other breast cancer research (Williams, "Nightly News," NBC, 10/10). Video of the segments is available online.

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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