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Title: Dose-Dense Chemotherapy Found More Effective Than Standard Delivery Times: Presented at SABCS

"Dose-Dense Chemotherapy Found More Effective Than Standard Delivery Times: Presented at SABCS"

By Ed Susman SAN ANTONIO, TX -- December 13, 2005 -- Doctors said that delivering chemotherapy more often than is done with current standard regimens results in better outcomes for women with high-risk breast cancer. However, the same 5-year study determined that the sequence in which breast cancer chemotherapy drugs were administered to patients made little difference in outcomes. "Dose-dense scheduling of chemotherapy once every 2 weeks is superior to every-3-week treatment," said Clifford Hudis, MD, chief, breast cancer medicine service, Memorial Sloan-Kettering Cancer Center, New York, New York, in presenting the results at the 28[^th Annual San Antonio Cancer Symposium (SABCS).

Dr. Hudis presented the results on 1972 evaluable patients in Intergroup Trial 9741, which was activated in 1997 and closed to accrual in 1999.

"We found a decreased hazard ratio of 25% for women who received chemotherapy over a 22-week period rather than a standard 33-week schedule," he said.

In one arm of the study patients received doxorubicin 60 mg/m² every 2 weeks over a 22-week period, cyclophosphamide over a 14-week period, and paclitaxel (Taxol). The other patients received doxorubicin for 33 weeks and cyclophosphamide for 21 weeks.

Over 7 years there were 168 events among the 988 dose-dense, 22-week group of patients compared with 202 events of recurrence among the 988 patients in the 33-week group, Dr. Hudis reported. He said the difference reached statistical significance at the P = .049 level.

In examining risk of disease free survival, Dr. Hudis said 230 events were reported in the dose-dense group compared with 278 events in the regular regimen. That difference was also statistically significant at the P = .012 level.

The researches also evaluated whether it made a difference when paclitaxel was added to the regimen. In some women it was administered after doxorubicin but before cyclophosphamide; in the others Taxol was delivered after both doxorubicin and cyclophosphamide.

There were no significant differences in outcomes either for overall survival or disease-free survival when assessed according to sequence, Dr. Hudis said.

He said that the study satisfies the theory that more frequent -- therefore denser -- dosing of chemotherapy is more effective because it decreases time for tumor regrowth, allows the treatment to target smaller volumes of diseased cells, and results in overall cell killing.

[Presentation title: Five Year Follow-up of INT C9741: Dose-Dense (DD) Chemotherapy (CRx) Is Safe and Effective. Abstract 41]

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