Dose-dense adjuvant therapy benefits?
Meet the Experts
Hope S. Rugo, M.D. is a clinical professor of medicine in the division of hematology and oncology at the University of California San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, where she directs the Breast Oncology Clinical Trials Program.
Jennifer Armstrong, M.D. is a breast cancer oncologist at Paoli Hematology-Oncology Associates in Paoli, Pa., with a special interest in physicians' communication skills.
Question from RoseB: My doctor told me that dose dense therapy in the adjuvant setting was discussed at ASCO and that no true clinical benefit was observed. Can you comment? Thank you.
- Answers —Hope Rugo, M.D.: Dose dense chemotherapy was tested in a randomized trial, and these patients are still being followed. There was a significant benefit in disease-free survival in women treated with dose dense therapy and that is still seen now. Disease-free survival was the primary goal, and dose dense therapy is the treatment given and superior to standard dosing. Data presented at ASCO suggested that dose dense therapy has its greatest effect in patients with hormone receptor negative disease. This is true of all chemotherapy regimens.
There was very preliminary survival data presented at ASCO as well. It suggests that although the degree of benefit of dose dense therapy is the same now as when initially presented, there's a difference due to the way events are calculated by statistics. The statistical significance is just below par. This does not mean that the regimen is not effective, nor does it change the data originally presented. In addition, longer term follow-up has approved the safety of dose dense treatment and allows chemotherapy to be given over four months instead of six months.
In the future, we will be able to choose therapies based on biologic characteristics of the tumor, as it is clear that some cancers will benefit more from either dose dense therapies or more aggressive regimens than others, but we do not yet have the ability to make those decisions. Therefore, I think dose dense therapy is still a very reasonable and well tolerated adjuvant therapy for women and is superior to every three week dosing when using Adriamycin and Cytoxan, followed by Taxol. (chemical names: doxorubicin, cyclophosphamide, paclitaxel) - Jennifer Armstrong, M.D.: I completely agree.
On Wednesday, June 15, 2005 our Ask-the-Expert Online Conference was called Updates from the 2005 ASCO Annual Meeting. Hope Rugo, M.D. and moderator Jennifer Armstrong, M.D. answered your questions on the latest research advances presented at the 2005 American Society of Clinical Oncology meeting in Orlando, FL.
The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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