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Do Breast Cancer Regimens Need Anthracycline?

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SAN ANTONIO -- Breast cancer patients may get similar benefit with less toxicity from adjuvant chemotherapy containing Taxotere and Herceptin but not the cardiotoxic anthracycline Adriamycin, researchers said.

SAN ANTONIO, Dec. 15 -- Breast cancer patients may get similar benefit with less cardiotoxicity if the anthracycline Adriamycin (doxorubicin) is dropped from the adjuvant chemotherapy regimen containing Taxotere (docetaxel) and Herceptin (trastuzumab).

So found the second interim analysis of the Breast Cancer International Research Group study (BCIRG 006), reported Dennis Slamon, Ph.D., of the University of California in Los Angeles, at the San Antonio Breast Cancer Symposium.

The second interim analysis included 3,222 patients with early stage HER2-positive breast cancer followed for a mean of three years. The patients were randomized to receive adjuvant therapy consisting of Herceptin-Cytoxan-Taxotere or Adriamycin-Cytoxan-Taxotere-Herceptin or the control regimen Adriamycin-Cytoxan-Taxotere.

Disease-free survival advantage at three years was similar between the Herceptin-containing arms with and without Adriamycin (6% and 5%, respectively), he said.

There was a reduction in relative mortality for the Herceptin- and Adriamycin-containing arm (41%, P

Regarding toxicity for the Adriamycin- and Herceptin-containing arm compared to the Herceptin arm without Adriamycin, the researchers reported:

  • Fewer cases of congestive heart failure (four versus 20, P=0.0015),
  • Fewer asymptomatic left ventricular ejection fraction declines (8.6 versus 18, P
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