Chemo beneficial in ER-poor breast cancer

Adjuvant chemotherapy for estrogen-receptor-poor (ER-poor) breast cancers is safe and reduces mortality and cancer recurrences in women younger than 70, according to the results of a large meta-analysis published in the Jan. 5 issue of The Lancet.

The Early Breast Cancer Trialists' Collaborative Group (EBCTCG) pooled data from roughly 6,000 women with ER-poor breast cancer participating in 46 clinical trials of polychemotherapy versus none, and roughly 14,000 women with ER-poor breast cancer in 50 trials of tamoxifen versus no tamoxifen.

In women with ER-poor breast cancers who were younger than 50 or aged 50 to 69, polychemotherapy reduced recurrences, breast cancer mortality, and all-cause mortality compared to no chemotherapy. In contrast to polychemotherapy, tamoxifen had little effect on risk of recurrence or death in women with ER-poor breast cancers. The trials included few women 70 and older.

"This latest update from the EBCTCG further confirms the contribution of chemotherapy to the decreasing recurrence of estrogen-receptor-negative breast cancer. Efforts should now be directed towards the establishment of finer definitions of subtypes of such cancers, the study of less debilitating but active regimens, and the development of new strategies for those who are not cured by conventional chemotherapy," writes the author of an associated editorial.

Early Breast Cancer Trialists' Collaborative Group. Clarke M, Coates AS, Darby SC, et al. Adjuvant chemotherapy in oestrogen-receptor-poor breast cancer: patient-level meta-analysis of randomised trials. Lancet. 2008;371:29-40.