A simple change in the schedule of breast cancer chemotherapy treatments can make the therapy much more effective, potentially saving thousands of lives a year, according to researchers who presented data at a major symposium today in San Antonio.
"I really did not expect to see such a dramatic difference from this relatively modest change," said Dr. Clifford Hudis, chief of breast cancer medicine at Memorial Sloan-Kettering Cancer Center in New York and an author of the study.
While surgery removes tumors from the breast, many women also undergo months of chemotherapy to kill hidden cancer cells in other parts of the body.
Some of these chemotherapy drugs are so toxic they're given only once every three weeks. Chemotherapy kills not only cancer cells but healthy cells as well, particularly white blood cells, which are critical in fighting any infection.
Over the last decade, however, a new drug called Neupogen has been available to help restore the body's white blood cells more quickly.
"That new medication," said Hudis, "allowed us to be more aggressive in the scheduling of chemotherapy. We could give it every two weeks instead of three and therefore kill more cancer cells."
That's because the shorter schedule seems to give cancer cells less time to recuperate and grow between chemotherapy treatments.
"Even though the treatments are closer together, you actually stay well longer. There's less infection and less fever," said patient Stephanie Ditullio, who is in the midst of chemotherapy treatments on the new, shorter schedule.
Study Finds Shorter Treatment to Prove Effective
Dr. Larry Norton, also of Memorial Sloan-Kettering and the senior author of the study, said there were many skeptics at first. "Many people thought that timing was not going to be so critical, that it was just the total amount of chemotherapy that was administered," he said.
At the San Antonio Breast Cancer Symposium, the researchers described how they gave the same dose, of the same chemotherapy drugs, to two groups of patients. Women in each group had breast cancer that had spread to their lymph nodes.
The only difference was: One group got treatment on the traditional three-week schedule, while the others received treatment every two weeks.
The study followed the women's health for four years and found that 25 percent of women who had been on the three-week schedule had their cancer reoccur, while the only 18 percent of those on the two-week schedule saw their cancer return.
Norton said the study also revealed that patients did not suffer any more side effects on the more frequent dosing schedule, and that most preferred it because they could finish the therapy a total of two months earlier.
The researchers say their study is just the beginning. They want to see whether they can shorten the chemotherapy schedule even further, from two weeks down to 10 days, to possibly save more lives.
Doctors are also studying whether a shorter treatment schedule can help not only breast cancer patients, but those suffering from prostate, lung or other cancers.