Chemotherapy 'super-cocktail' cuts breast cancer deaths by 30%

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Doctors have announced that a chemotherapy "super-cocktail" given to women with breast cancer reduced deaths by more than 30 per cent, compared with standard treatment.

The improvement in survival was described as "dramatic" and exceeded the expectations of researchers from the University of Birmingham, who conducted separate studies in England and Scotland. It confirms earlier results, reported in 2003.

But the specialist who led the studies said many women with breast cancer in the UK were not being treated with the right dose of chemotherapy in the right schedule to maximise their chances of survival.

Chemotherapy is given to women with early breast cancer, after surgery and radiotherapy to mop up any molecules of the cancer that may have spread round the body to other organs. Its use has been established since 1976 after trials showed that the standard three-drug chemotherapy cocktail improved survival rates.

Adding the fourth drug, epirubicin, reduced the death rate by more than 30 per cent compared with standard chemotherapy, and by 50 per cent compared with no chemotherapy, in the studies of 2,400 women treated at 75 hospitals across the UK.

The results of the studies, funded by Cancer Research UK and others, are published today in the New England Journal of Medicine.

Chris Poole, the consultant medical oncologist at the University of Birmingham, said: "The results show conclusively that the addition of epirubicin to chemotherapy has a significant impact on survival in early stage breast cancer."

Dr Poole said that most women with breast cancer in the UK would be treated with epirubicin. "But whether they are getting it in the right dose and on the right schedule is another matter," he said.

High doses of epirubicin were administered for the first four cycles of treatment but it was then replaced with standard chemotherapy, maximising the impact of the drug but minimising the long-term risks, such as leukaemia.

The women were recruited to the study between 1996 and 2001 to look at the recurrence of tumours and survival rates. Unlike the hormonal treatment Herceptin, which is effective in only 20 per cent of patients with oestrogen-positive breast cancer, chemotherapy works for all women.

"It is an old-fashioned, blunderbuss treatment. It does seem to be uniformly effective," Dr Poole said.

The evidence showed that the effects of hormonal drugs such as Herceptin given after chemotherapy had a cumulative effect, on top of any survival gain achieved by the chemotherapy, Dr Poole said.

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