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Anthracycline Use Questioned for Some Breast Cancers

Effectiveness of anthracyclines limited to HER2-positive breast cancer

WEDNESDAY, Jan. 9 (HealthDay News) -- Patients with HER2-positive breast cancer are more likely to respond to anthracycline-based chemotherapy than those with HER2-negative disease, according to study findings published in the Jan. 2 issue of the Journal of the National Cancer Institute.

Alessandra Gennari, M.D., Ph.D., from the National Cancer Research Institute in Genoa, Italy, and colleagues pooled the results of eight randomized, controlled trials (involving 6,564 patients) on the efficacy of anthracycline- versus non-anthracycline-based chemotherapy for early breast cancer based on HER2 status, which was available for 5,354 patients.

The researchers found that anthracycline-based chemotherapy significantly improved both disease-free and overall survival, but only in patients with HER2-positive breast cancer (pooled hazard ratios 0.71 and 0.73, respectively). The chi-square statistics for the interaction were significant at 13.7 for disease-free and 12.6 for overall survival.

"The absence, in our study, 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," Gennari and colleagues conclude.

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