PARIS--New analyses from the mega-databank of the Early Breast
Cancer Trialists' Collaborative Group (EBCTCG) have confirmed
that both ovarian ablation and polychemotherapy make a small but
real difference in survival, Professor Richard Peto, of the University
of Oxford's ICRF Clinical Trial Service Unit, said at the Sixth
International Congress on Anti-Cancer Treatment (ICACT).
Previous reports from this overview of 200 trials involving 100,000
women have spotlighted a similar benefit with tamoxifen (Nolvadex),
but have found no survival advantages for adjuvant radiotherapy
vs no radiotherapy or for mastectomy vs breast-conserving surgery.
Speaking on behalf of the EBCTCG, Professor Peto said that 10-year
overall survival was 60.6% for breast cancer patients under the
age of 50 who had undergone ovarian ablation, as compared with
56.2% for those who had not. This difference was maintained for
up to 15 years, when overall survival was 52.9% with ovarian ablation
vs 47.4% without (P = .004).
"The differences in recurrence-free survival were even more
definite, so the idea that breast cancer in women under 50 is
not sensitive to hormone therapy just isn't true," he said.
"It's not a large difference, but it's as big as the effect
of streptokinase and aspirin in reducing mortality after myocardial
A 5% edge in overall survival also emerged for patients who had
been treated with multiple chemotherapeutic agents, relative to
those who had not received polychemotherapy. Professor Peto said
that this benefit was independent of the particular multiple chemotherapeutic
"You can actually get double the benefit by using double
treatment," he continued, noting that chemotherapy combined
with tamoxifen yielded better results than either approach used
[Editors' Note: Professor Peto's report on the latest EBCTCG metaanalysis
of tamoxifen trials appeared on page 1 of the January, 1996, issue
of Oncology News International.]