Epirubicin Enhances Therapy for Early Breast Cancer

Two studies show better relapse-free and overall survival when epirubicin added to regimen

THURSDAY, Nov. 2 (HealthDay News) -- Epirubicin in addition to cyclophosphamide, methotrexate and fluorouracil (CMF) is a better adjuvant therapy for early breast cancer than just CMF alone, according to a report in the Nov. 2 issue of the New England Journal of Medicine.

Christopher J. Poole, F.R.C.P., at the University of Birmingham in the U.K., along with the National Epirubicin Adjuvant Trial (NEAT) group members and the Scottish Cancer Trials Breast Group (SCTBG) compared four cycles of epirubicin followed by four cycles of CMF with six cycles of CMF-alone for treatment of 2,391 women with early breast cancer.

Relapse-free and overall survival rates after two and five years were higher in the epirubicin plus CMF group than the CMF-alone group. For example, relapse-free and overall survival at five years were 76 and 82 percent for the epirubicin plus CMF group but only 69 and 75 percent for the CMF-alone group, respectively. Adverse effects were higher for the epirubicin plus CMF group but did not affect treatment or quality of life.

Each trial used a different CMF regimen and did not include data regarding radiation and tamoxifen treatment, both of which can influence outcome, according to an editorial by Mark N. Levine, M.D., and Timothy Whelan, B.M., B.Ch. "It is reassuring," they add, "that…the benefit of the sequential regimen was seen in both trials."

A number of the authors of the original study have received grant support or compensation from Pharmacia (now Pfizer) or other pharmaceutical companies.

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