Paclitaxel beneficial in HER2-positive breast Ca

HER2-positive women with node-positive breast cancer who received paclitaxel after adjuvant treatment are more than 40% less likely to experience a recurrence (HR, 0.59). But the addition of paclitaxel was of no benefit in women with HER2-negative, estrogen-receptor-positive cancers. Women expressing human epidermal growth factor receptor type 2 (HER2) appear to benefit from the addition of paclitaxel regardless of estrogen-receptor status, according to study findings published in the Oct. 11 issue of the New England Journal of Medicine.

Daniel F. Hayes, MD, of the University of Michigan Comprehensive Cancer Center in Ann Arbor, and colleagues studied 1,500 women treated with doxorubicin and cyclosphosphamide who were randomly assigned to receive either four cycles of paclitaxel or observation.

"Hayes and his coauthors caution us not to change clinical practice on the basis of their retrospective analysis, but oncologists have a responsibility to their patients to be aware of this report," states the author of an accompanying editorial. "A similar trial of doxorubicin plus cyclophosphamide followed by paclitaxel involving 3,100 patients was published by the National Surgical Adjuvant Breast and Bowel Project in 2005. The results showed a small benefit in 5-year disease-free survival but no difference in overall survival as a result of the addition of paclitaxel in women with estrogen-receptor-negative or estrogen-receptor-positive disease." (Several authors report receiving consulting fees from Bristol-Myers Squibb and Abbott.)

Hayes DF, Thor AD, Dressler LG, et al. HER2 and response to paclitaxel in node-positive breast cancer. N Engl J Med. 2007;357:1496-1506.