Saturday, May 23, 2009

2009 ASCO conference-Triple Negative News

The ASCO conference is in Orlando this year and will begin on May 31.
They have released some of the Abstracts that will be discussed.
One in particular caught my eye.
It is about the effectiveness of anthracycline therapy on basal, triple negative breast cancer vs CMF.
It appears that CMF is superior to Adriamycin and Epirubicin in this particular trial.
However, these same drugs are superior to CMF in NON-basal, Her2+ breast cancers.

I was diagnosed in 2001 with Triple Negative Breast Cancer. I received CMF. The triple negative cancer has not returned. Yet, I did get a new primary which was estrogen and progesterone positive for which I received Adriamycin.

The following is a copy from the ASCO site

Anthracyclines in basal breast cancer: The NCIC-CTG trial MA5 comparing adjuvant CMF to CEF.

Sub-category: Adjuvant Therapy

Category: Breast Cancer--Local-Regional and Adjuvant Therapy

Meeting: 2009 ASCO Annual Meeting

Citation: J Clin Oncol 27:15s, 2009 (suppl; abstr 519)

Abstract No: 519

Author(s): M. Cheang, S. K. Chia, D. Tu, S. Jiang, L. E. Shepherd, K. I. Pritchard, T. O. Nielsen; University of British Columbia, Vancouver, BC, Canada; BC Cancer Agency, Vancouver, BC, Canada; NCIC Clinical Trials Group, Kingston, ON, Canada; University of Toronto, Toronto, ON, Canada


Background: MA5 randomized premenopausal women with node-positive early breast cancers to cyclophosphamide- methotrexate-fluorouracil (CMF) or cyclophosphamide-epirubicin-fluorouracil (CEF) adjuvant chemotherapy. This and other trials have shown that adjuvant regimens containing anthracyclines confer significant survival benefit to breast cancer patients. Meta-analyses have revealed most benefit in women with HER2(+) or TOPO2 (+) tumors. Population-based data suggest that patients with a core basal phenotype (negative for hormone receptors and HER2, positive for CK5/6 or EGFR) conversely have worse survival on anthracycline containing vs. CMF regimens. Here we test the hypothesis specified a priori that for basal breast cancers anthracyclines may be inferior, using data from MA5. Methods: From 710 patients in MA5, blocks suitable for tissue microarray construction were recovered for 549. Immunohistochemistry for ER, PR, HER2, Ki67, CK5/6 and EGFR was obtained, allowing stratification of 511 cases into intrinsic biological subtypes by published methods (Cheang MC et al. Clin Cancer Res 2008;14:1368-76). Prespecified analyses were conducted independently by the NCIC- CTG statistical centre. Results: In the CEF arm, patients with core basal tumors had a hazard ratio of 1.8 (log rank p=0.02) for overall survival (OS) relative to the other biological subtypes. In the CMF arm, there was no significant difference (HR 0.9, p = 0.7). The interaction between core basal status and treatment was borderline significant (p=0.06). Relapse free survival differences did not reach significance. Conclusions: Data from this randomized trial supports the hypothesis that anthracycline containing adjuvant chemotherapy regimens are inferior to adjuvant CMF in women with basal breast cancer.

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