Public Release:  Anthracyclines improve survival in HER2-positive breast cancer patients

Journal of the National Cancer Institute

Treatment with the class of chemotherapy drugs called anthracyclines improves survival in women with HER2-positive breast cancer who have previously had surgery, but it may not offer any benefit for women with HER2-negative tumors, according to a study published online December 25 in the Journal of the National Cancer Institute.

Randomized clinical trials have demonstrated that treating early breast cancer with anthracycline-based chemotherapy improves disease-free and overall survival rates more than non-anthracycline-based regimens. However, the studies have demonstrated that anthracyclines may slightly increase the risk of heart damage and leukemia. Given these side effects, the greatest benefit of these regimens may be in women with breast tumors that overexpress HER2--a gene that is often amplified in tumors that respond to anthracyclines.

Alessandra Gennari, M.D., Ph.D., of the National Cancer Research Institute in Genoa, Italy, and colleagues compiled data from eight randomized controlled trials that compared anthracyclines and non-anthracyclines, and also reported HER2 status. Almost 30 percent of the patients' tumors overexpressed HER2.

Overall and among patients with HER2-positive tumors, anthracycline-based chemotherapy produced a greater reduction in the risk of relapse or death than non-anthracycline-based regimens. However, among patients with HER2-negative tumors, there was no difference in survival between the chemotherapy regimens.

"The absence...of any effect of anthracyclines observed in patients with HER2-negative disease suggests that this group of patients could be spared unnecessary toxic effects related to the use of this class of agents and raises questions as to the appropriateness of control arms in randomized clinical trials in which anthracycline-based regimens are used in unselected patient populations," the authors write.

In an accompanying editorial, Soonmyung Paik, M.D., of the National Surgical Adjuvant Breast and Bowel Project in Pittsburgh and colleagues point out that HER2 status alone may not be enough to determine who should receive anthracyclines, given the molecular differences among different subtypes of breast cancer.

"Optimization of adjuvant chemotherapy for patients diagnosed with breast cancer will depend on defining the baseline prognosis and chemosensitivity of each subclass of breast cancer beyond those crudely defined by HER2 status alone," the editorialists write.

###

Contact:

  • Article: Media Office at the National Cancer Research Institute, gemma.dagnino@istge.it, +39 010 5600605 or Alessandra Gennari, alessandra.gennari@istge.it, +39 010 5737369

  • Editorial: Holly McCalmon, director of communications, National Surgical Adjuvant Breast and Bowel Project, holly.mccalmon@nsabp.org, (412) 330-4616

    Citation:

  • Article: Gennari A, Sormani MP, Pronzato P, Puntoni M, Colozza M, Pfeffer U, Bruzzi P. HER2 Status and Efficacy of Adjuvant Anthracyclines in Early Breast Cancer: A Pooled Analysis of Randomized Trials. J Natl Cancer Inst 2008; 100:14-20

  • Editorial: Paik S, Taniyama Y, Geyer CE Jr. Anthracyclines in the Treatment of HER2 -Negative Breast Cancer. J Natl Cancer Inst 2008; 100:2-4

    Note to Reporters:

    We have started up an e-mail list to alert reporters when papers are available on the EurekAlert site. If you would be interested on being on this list, please let us know at jncimedia@oxfordjournals.org. The content will continue to be available through EurekAlert's e-mail system and our EurekAlert page.

    The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage. Visit the Journal online at http://jnci.oxfordjournals.org/.

  • Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.