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Avastin May Help Fight Early Breast Cancer

Studies May Reopen Discussions About Benefits of Avastin for Breast Cancer

Is Early Chemotherapy Better?

Indeed, Daly says studies that have compared women who’ve had chemotherapy before surgery to those who only had it after their procedures have found no survival advantage to the pre-surgery treatment.

“We’ve been burned before looking at early outcomes and assuming they will translate into late outcomes, only to find out that, in fact, it doesn’t translate,” says Daly, who reviewed the studies for WebMD but was not involved in the research.

“So the fact that at surgery, there was a little difference in the complete response rate ... doesn’t necessarily mean that those women are going to live longer, and live longer free of their disease,” she says.

Other experts agree.

“In the end, survival is really what matters,” says Alberto J. Montero, MD, an oncologist and assistant professor of medicine at the University of Miami’s Sylvester Comprehensive Cancer Center.

Montero wrote an editorial on the studies but was not involved in the research.

Researchers say the studies have continued to follow their patients, and they should be able to report on whether or not Avastin improves their chances of survival in the next few years.

Testing Avastin for Early-Stage Breast Cancers

While both studies showed some success when using Avastin, the types of breast cancer they worked on were different, making the sum result from the two studies a little murky.

For the first study, researchers in Germany assigned almost 2,000 women with newly diagnosed breast cancers to receive either six months of chemotherapy with the drugs epirubicin and cyclophosphamide followed by docetaxel alone or with Avastin.

About 15% of patients treated with epirubicin and cyclophosphamide followed by docetaxel saw their tumors disappear completely by the time of their surgery. 

That number was slightly higher in the group that also got Avastin -- about 18%.

The second study, which was based in the U.S., tested whether Avastin improved complete response when added to the chemotherapy drug docetaxel alone or with either capecitabine or gemcitabine, followed by treatment with doxorubicin-cyclophosphamide, in 1,200 women.

As in the first study, more women saw their tumors disappear when Avastin was added to their pre-surgery chemotherapy -- about 35% had a complete response in the Avastin group compared to about 28% in the group that got chemotherapy alone.

That’s where the similarities ended.

When the German researchers took at closer look at their results, they were surprised to find that women whose cancers were not spurred by hormones -- so called triple-negative tumors -- were seeing larger-than-average benefits from Avastin.

Triple-negative tumors account for only about 10% to 20% of breast cancer, but they are among the toughest to treat. Studies have shown they are more likely to spread and recur than tumors that are sensitive to hormones.

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