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| |  No Subgroup Benefit Found in Meta-Analysis of High-Dose Chemotherapy/Stem Cell Transplantation for Breast Cancer: Presented at SABCS By Ed Susman SAN ANTONIO, TX -- December 14, 2007 -- A review of 15 studies involving high-dose chemotherapy followed by autologous stem cell transplantation showed that this therapy is not beneficial for women with high-risk breast cancer. "Several studies have suggested that the more you do in high-risk breast cancer, the better [the outcomes would be]," said Donald Berry, PhD, Professor and Head, Division of Quantitative Sciences, University of Texas M.D. Anderson Cancer Center, Houston, Texas. "Yet, there is a limit, and we seem to have reached a plateau." Dr. Berry discussed the results here on December 13 at the 30th San Antonio Breast Cancer Symposium (SABCS). His analysis was based on a review of 15 studies involving 6,210 patients who were followed for an average of 7 years. The studies compared 3,092 patients who underwent standard chemotherapy and 3,118 patients who received high-dose chemotherapy. The patients had an average age of 45 years and had an average of 12 positive lymph nodes, putting them at high risk for breast cancer recurrence. The overall survival rates over 7 years of the two groups were identical, with a 6% difference (P =.21) emerging after 13 years of treatment. When Dr. Berry examined subgroups he was unable to find any group that benefited from the high-dose therapy. He analyzed various patient subgroups (< vs > than 50 years old; pre- vs postmenopausal; < or > 10 positive nodes; histology; hormone receptor status). Results showed that patients who had fewer positive nodes had better survival rates. However, there was no advantage to having undergone the arduous high-dose chemotherapy with stem cell transplantation. "We found that there is a modest benefit of high-dose chemotherapy on relapse-free survival," Dr. Berry said, "but little or no benefit on overall survival." "Even after adjusting for trial and dose differences, we were not able to tease out more than a marginal benefit for greater dose intensity," he said. Once patients have received the ultimate amount of chemotherapy for their tumor type, "there's no advantage from additional benefit. The remainder of patients had tumors that are not sensitive to the chemotherapy being considered and would not benefit, no matter how much [drug] you give them."
[Presentation title: High-Dose Chemotherapy With Autologous Stem-Cell Support Versus Standard-Dose Chemotherapy: Meta-Analysis of Individual Patient Data From 15 Randomized Adjuvant Breast Cancer Trials. Abstract 11]
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