High-Dose Chemo Provides Little Benefit to Breast Cancer Patients

By Amanda Gardner
HealthDay Reporter
Friday, December 14, 2007; 12:00 AM

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THURSDAY, Dec. 13 (HealthDay News) -- High-dose chemotherapy has only a minimal effect on survival in breast cancer patients with node-positive disease, new research shows.

"It's pretty clearly established that [high-dose chemotherapy] is a false hope," said study author Donald Berry, head of the Division of Quantitative Sciences at the University of Texas M.D. Anderson Cancer Center in Houston. "There's a disease-free survival benefit but not much of a survival benefit. There may be a subset which would benefit, but we looked and couldn't find it."

The study, done in collaboration with the European Blood and Marrow Transplant Group, essentially sounds the death knell for this type of therapy.

"When you're doing a meta-analysis and combining large numbers of studies with different populations, and you're not able to get a really significant survival advantage, I think that the benefits of high-dose chemo are not there," added Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La. "Outside of a clinical research trial, I do not recommend high-dose chemotherapy."

The findings are expected to be presented Thursday at the San Antonio Breast Cancer Symposium.

High-dose chemotherapy for breast cancer has a somewhat controversial history. The treatment is delivered in conjunction with an autologous (from the same person) bone marrow transplant, which rebuilds bone marrow damaged by the chemotherapy. The regimen was at one time favored for high-risk patients (those whose cancer has spread to at least four lymph nodes).

The rationale for the treatment came from successes in the 1960s and 1970s in treating certain leukemia patients with radiation and high-dose chemotherapy, along with bone marrow transplants.

By the late 1980s, the regimen was all the rage. An estimated 20,000 to 30,000 U.S. women have undergone high-dose chemotherapy with bone marrow transplants.

"Ten years ago, if a woman didn't get a bone marrow transplant, people were suing HMOS, because they said they were denying care," Brooks said. "The cases won."