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| |  RSM: Missed Treatment Opportunities Compromise Survival Rates for British Cancer Patients LONDON, ENGLAND -- July 25, 2001 -- Results from two cancer treatment audits(1) presented today at the Royal Society of Medicine (RSM) reveal important differences in chemotherapy administration in the United Kingdom compared to Europe and the United States, where survival rates are higher. The audits, supported by the biopharmaceutical company, Amgen, involved 422 patients with primary breast cancer and 177 with advanced lymphoma from 23 cancer units throughout the UK. The findings were previewed at scientific meetings in the USA; The American Society of Haematology (ASH)(2) and The American Society of Clinical Oncology Meeting (ASCO)(3). Strong evidence suggests that maintaining chemotherapy dose levels over a planned treatment duration (known as delivering the planned chemotherapy dose intensity) gives patients a better chance of survival(4,5). Despite knowledge of this relationship, chemotherapy dose intensity levels delivered to patients in the UK are lower than in Europe and the USA(6). Although UK patients start chemotherapy courses with the intention that they receive the full protocol dose, the audits showed that 30 percent with breast cancer and 47 percent with lymphoma had their chemotherapy dose modified. This was due to the fact that the dose level was reduced at each subsequent course or there was a delay in when it should be given. More specifically, in the breast cancer audit, a mean of 36 percent of patients received less than 85 percent of their planned chemotherapy dose intensity, a threshold widely accepted by cancer doctors to reflect inferior survival. "If you believe chemotherapy improves survival for cancer patients then you should believe that giving the right dose is crucial to its success," says Dr. Rob Thomas, a Consultant Cancer specialist at Addenbrooke's Hospital, Cambridge University, speaking at the RSM today, "and there is plenty of scientific evidence to support this." The main reason for dropping the chemotherapy dose intensity is the common and serious side effect, neutropenia. When it strikes, the level of white cells in the blood falls dramatically. These are the cells that protect the body from infection and prevent it spreading through the blood stream. Known as septicaemia, this infection can have devastating consequences for patients, all of whom feel very unwell, require urgent admission to hospital and the administration of intravenous antibiotics. If treated early, antibiotics do save the majority of these patients. None-the-less, neutropenic septicaemia remains a recognised fatal consequence for an unfortunate minority (approximately 10 percent)(7). Understandably, cancer doctors want to protect their patients from these unwelcome side effects. To do so they reduce the chemotherapy dose intensity and although kind in the short term this intervention does increase the risk of the most serious toxicity, that of the cancer coming back. "This drug is vastly under-used in the UK," said Dr. Thomas, "and current lack of funding continues to severely restrict the prescription of supportive care drugs." Dr. Thomas's view was echoed in a report by the Campaign for Effective Rational Treatment (CERT)(8), showing the widening gap between the UK and similar European countries in the use of new anti-cancer drugs together with supportive therapies. As a result, patients in the UK continue to have less chance of surviving cancer. The Campaign for Effective Rational Treatment concluded that under-investment in the National Health System (NHS) was directly linked to these findings. SOURCE: Amgen Limited
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