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| |  SABCS: No Connection Between Anemia and Outcome in Patients Undergoing Breast Cancer Chemotherapy By Ed Susman SAN ANTONIO, TX -- December 11, 2001 -- Results from the German Preoperative Adriamycin/Docetaxel (GEPARDO) trial show no association between anemia and tumor response in patients treated with dose-intensified preoperative chemotherapy. "Anemia does not appear to make any difference in outcome," said Dr. Wolfgang Eiermann, a professor of medicine at the Frauenklinik vom Roten Kreuz, in Munich, Germany. "Anemia certainly affects a person as far as fatigue and other quality of life issues are concerned", he said, "but there is no effect on the tumor". These findings about how anemia affects breast cancer are in contrast to those of previous studies. "In breast cancer patients, it has been shown that anemia induced by adjuvant chemotherapy has a negative effect on quality of life. As tumor response to preoperative chemotherapy is assumed to be a surrogate marker for prognosis, we examined the relationship between anemia and remission rates in the neoadjuvant setting," Dr. Eiermann said. The research team, from 56 centers in Germany, recruited 250 patients with tumors greater than 3 cm in diameter, whose cancer had not metastasised prior to initial surgery. The doctors recorded hemoglobin levels in 248 of the patients. Patients were treated preoperatively with a dose-intensified regimen of Adriamycin 50 mg/mē - docetaxel 75 mg/mē daily every other week over four cycles. Tamoxifen was also provided to one group of patients, but not the other. The patients were supported with filgrastim during days 5-10. Laboratory tests included histological typing, tumor grading and receptor status determination. There was a pathological complete response rate of 9.7 percent with no difference in the two treatment arms. Blood samples were taken prior to each cycle of chemotherapy and the decrease of hemoglobin was classified according to World Health Organization (WHO) toxicity criteria. Low-grade anemia occurred in 206 or 83.4 percent of patients; high-grade anemia occurred in 16.6 percent of patients. Patients were evaluated on the bases of tumor size, tumor grading, estrogen receptor status or tumor response. The researchers determined that anemia did not affect any of these parameters. We concluded from these investigations that anemia induced by preoperative dose-intensified chemotherapy is independent [of] these factors, does not exceed the expected range and has no impact on remission rates of the patients, Dr. Eiermann said. He suggested that work in his laboratory appears to show that key breast cancer tumor genetics may depict a hypoxic state, and therefore the amount of oxygen in the blood would not be a good indicator of how the tumor would react to chemotherapy.
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