Adverse effects and costs of chemotherapy greater than previously thought www.support-cancer-research.com/treatmentopt.html Researchers at Dana-Farber Cancer Institute and Harvard Medical School have found that breast cancer patients 63 years of age or younger may experience more chemotherapy-related serious adverse effects than reported in clinical trials, according to a new study in the August 16 issue of the Journal of the National Cancer Institute. Led by Michael J. Hassett, MD, MPH, of Dana-Farber, researchers studied a database of medical claims made by women with newly diagnosed breast cancer who had employer-provided health insurance between January 1998 and December 2002. "This is the first study, to our knowledge, of chemotherapy-related serious adverse effects in a population-based sample of younger women with breast cancer," said Hassett, who is also an instructor in medicine at Harvard Medical School. "We found that eight chemotherapy-related serious adverse effects may be more common than reported in large clinical trials, and, therefore, these adverse effects may be responsible for more patient suffering and higher health care expenditures than currently predicted." Doctors often prescribe chemotherapy to eliminate residual cancer cells in women who have undergone surgery for breast cancer. Women who received chemotherapy were more likely to be hospitalized or visit emergency rooms for problems that are typically related to chemotherapy, including fever or infection, low white blood cell or platelet count, nausea, diarrhea, malnutrition, or dehydration. Researchers studied 7,052 women from a database of claims made to health plans that contract with large employers in the U.S. The group was equally divided into two cohorts of 3,526: those who received chemotherapy within 12 months of their first breast cancer diagnosis, and those who did not. In addition to more incidents of chemotherapy-related adverse effects, women undergoing chemotherapy for breast cancer also experienced increased healthcare costs: $1,271 more per year for hospitalizations and emergency room visits and $17,617 more per year for ambulatory care than women who did not receive chemotherapy. Additional contributors of the report are from Dana-Farber and the Harvard School of Public Health. The research was funded by grants from the Agency for Healthcare Research and Quality and the National Institutes of Health. Dana-Farber Cancer Institute (www.dana-farber.org) is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC), designated a comprehensive cancer center by the National Cancer Institute. Media Contacts: Teresa Herbert or Robert Levy, (617) 632-4090. Press Releases Email this page

	Switching to Aromasin® Improves Survival Among Postmenopausal Women with Early Breast Cancer Medical Blogs: Expert Blogs Breast Cancer - Breast Cancer Chronicles by Lillie ... Kevin, M.D. - Medical Weblog NHS Blog Doctor: Breast cancer screening : mammography NHS Blog Doctor: Improving the care of breast cancer patients TIME.com: The Daily Rx - Health News - Medical News Trusted.MD Network | Empowering Healthcare Relationships Cancer blogs The Cancer Blog Comprehensive medical information for patients and physicians Switching to Aromasin® Improves Survival Among Postmenopausal Women with Early Breast Cancer Breast cancer patients who switch to Aromasin® (exemestane) after 2–3 years of Nolvadex® (tamoxifen) are less likely to experience cancer recurrence or cancer in the opposite breast, and have better overall survival, than women who remain on Nolvadex. These results were presented at the 2006 annual meeting of the American Society of Clinical Oncology (ASCO). Each year, breast cancer is diagnosed in over 200,000 women in the U.S. alone. Many of these breast cancers will be hormone receptor-positive, meaning that they are stimulated to grow by the circulating female hormones estrogen and/or progesterone. Treatment of hormone receptor-positive breast cancer often involves hormonal therapies that suppress or block the action of estrogen. These therapies include Nolvadex as well as a group of drugs referred to as anti-aromatase agents. Nolvadex acts by blocking estrogen receptors, whereas anti-aromatase agents suppress the production of estrogen. Aromasin is an anti-aromatase agent. To assess the effect of switching to Aromasin after 2–3 years of Nolvadex, researchers conducted a clinical trial called the Intergroup Exemestane Study. The trial enrolled 4,724 postmenopausal women with estrogen receptor-positive, early breast cancer. After 2–3 years of Nolvadex, women were randomly assigned to continue on Nolvadex or to switch to Aromasin. Women were treated with Nolvadex or Nolvadex followed by Aromasin for up to five years. Women have now been followed for a median of close to five years. The following results exclude 122 patients who were found to be estrogen receptor-negative after the start of the study. Compared to women who remained on Nolvadex, women who switched to Aromasin had a 25% lower risk of cancer recurrence or development of a new cancer. Women who switched to Aromasin had a 17% lower risk of death compared to women who remained on Nolvadex. Women who switched to Aromasin were less likely to experience blood clots or gynecologic problems (such as uterine cancer), but more likely to experience a bone fracture. These results suggest that switching to Aromasin after 2–3 years of Nolvadex improves both overall and cancer-free survival among among postmenopausal women with early breast cancer. Switching to Aromasin increased the risk of bone fractures but decreased the risk of blood clots and serious gynecologic problems. Reference: Coombes RC, Paridaens R, Jassem J et al. First Mature Analysis of the Intergroup Exemestane Study: a Randomized Trial in Disease-free, Postmenopausal Patients with Early Breast Cancer Randomized to Continue Tamoxifen to to Switch to Exemestane Following an Initial 2-3 Years of Adjuvant Tamoxifen. Presented at the 2006 ASCO Annual Meeting. Abstract #LBA527. Related News: Aromasin® Improves Breast Cancer Outcomes Without Compromising Quality of Life (2/28/2006) Aromasin® Approved for Early Breast Cancer (10/10/2005) Breast cancer patients who switch to Aromasin® (exemestane) after 2–3 years of Nolvadex® (tamoxifen) are less likely to experience cancer recurrence or cancer in the opposite breast, and have better overall survival, than women who remain on Nolvadex. These results were presented at the 2006 annual meeting of the American Society of Clinical Oncology (ASCO). Each year, breast cancer is diagnosed in over 200,000 women in the U.S. alone. Many of these breast cancers will be hormone receptor-positive, meaning that they are stimulated to grow by the circulating female hormones estrogen and/or progesterone. Treatment of hormone receptor-positive breast cancer often involves hormonal therapies that suppress or block the action of estrogen. These therapies include Nolvadex as well as a group of drugs referred to as anti-aromatase agents. Nolvadex acts by blocking estrogen receptors, whereas anti-aromatase agents suppress the production of estrogen. Aromasin is an anti-aromatase agent. To assess the effect of switching to Aromasin after 2–3 years of Nolvadex, researchers conducted a clinical trial called the Intergroup Exemestane Study. The trial enrolled 4,724 postmenopausal women with estrogen receptor-positive, early breast cancer. After 2–3 years of Nolvadex, women were randomly assigned to continue on Nolvadex or to switch to Aromasin. Women were treated with Nolvadex or Nolvadex followed by Aromasin for up to five years. Women have now been followed for a median of close to five years. The following results exclude 122 patients who were found to be estrogen receptor-negative after the start of the study. Compared to women who remained on Nolvadex, women who switched to Aromasin had a 25% lower risk of cancer recurrence or development of a new cancer. Women who switched to Aromasin had a 17% lower risk of death compared to women who remained on Nolvadex. Women who switched to Aromasin were less likely to experience blood clots or gynecologic problems (such as uterine cancer), but more likely to experience a bone fracture. These results suggest that switching to Aromasin after 2–3 years of Nolvadex improves both overall and cancer-free survival among among postmenopausal women with early breast cancer. Switching to Aromasin increased the risk of bone fractures but decreased the risk of blood clots and serious gynecologic problems. Reference: Coombes RC, Paridaens R, Jassem J et al. First Mature Analysis of the Intergroup Exemestane Study: a Randomized Trial in Disease-free, Postmenopausal Patients with Early Breast Cancer Randomized to Continue Tamoxifen to to Switch to Exemestane Following an Initial 2-3 Years of Adjuvant Tamoxifen. Presented at the 2006 ASCO Annual Meeting. Abstract #LBA527. Related News: Aromasin® Improves Breast Cancer Outcomes Without Compromising Quality of Life (2/28/2006) Aromasin® Approved for Early Breast Cancer (10/10/2005)