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SABCS: Combo Treatment Beneficial in Breast Cancer

Adding chemotherapy to tamoxifen reduces relapses, improves survival in high-risk women

FRIDAY, Dec. 11 (HealthDay News) -- In postmenopausal women with hormone-receptor positive, node-positive breast cancer, addition of chemotherapy to standard tamoxifen treatment significantly improves disease-free survival compared to tamoxifen alone, according to a study published online Dec. 11 in The Lancet to coincide with the annual San Antonio Breast Cancer Symposium, held from Dec. 9 to 13.

Kathy S. Albain, M.D., of the Loyola University Stritch School of Medicine in Maywood, Ill., and colleagues randomly assigned 1,477 women to receive either tamoxifen only, chemotherapy followed by tamoxifen (CAF-T), or chemotherapy plus concurrent tamoxifen (CAFT).

After a maximum follow-up of 13 years, the researchers found that women randomized to either CAF-T or CAFT were less likely to die from disease-related causes than women randomized to tamoxifen only. Overall survival was also improved in the combined groups, but only marginally. The researchers also found that the adjusted hazard ratios favored CAF-T over CAFT, but that the findings did not reach significance for disease-free or overall survival.

"We believe that for postmenopausal women with few comorbidities who have a substantial risk of recurrence or death based on the prognostic profile of their tumor, the risk-benefit balance favors anthracycline-based chemotherapy followed by tamoxifen," the authors conclude. "However, characteristics of the tumor should also be factored into the risk-benefit ratio. This study shows the necessity of long-term follow-up of adjuvant therapies to determine the outcomes of treatment."

The study was funded by the National Cancer Institute.

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