Breast cancer survival advance

Researchers from Australia and New Zealand believe they have achieved a rare advance in extending survival for women with advanced breast cancer.

A trial, conducted by the Australian New Zealand Breast Cancer Trials Group, included 323 women from 34 centres in Australia and New Zealand, and its results were reported recently at the San Antonio Breast Cancer Symposium, the world’s premier breast cancer conference.

Participating women were randomly allocated and treated to either capecitabine tablets given for 14 of every 21 days, capecitabine tablets given for 21 of every 21 days, or to classical CMF (a standard chemotherapy combination including injections of methotrexate and fluorouracil twice a month, and tablets of cyclophosphamide for 14 days each month). The aim of the trial was to see if women treated with capecitabine would do and feel better than those treated with CMF.

The underlying idea was that capecitabine would be at least as good as CMF at
controlling the cancer, but would maintain control for longer because it is better tolerated and can be continued for longer. The trial focused on women starting chemotherapy for advanced breast cancer, but unsuited to intensive chemotherapy. These women are rarely included in trials, even though they represent the majority of those affected by breast cancer.

The trial showed that overall survival was significantly longer with capecitabine than CMF. The typical survival time was 22 months on capecitabine versus 18 months on CMF. Control of the cancer over the first six months was similar on capecitabine and CMF, but capecitabine was more likely to control the cancer beyond six months.

Chemotherapy was continued for longer than six months in 40% of women on capecitabine but only 21% of women on CMF. Side effects were less severe and more tolerable with capecitabine than cmf, the trial demonstrated.