Tegafur-uracil-tamoxifen combination effective for stage II breast cancer

The combination of tegafur, uracil, and tamoxifen is effective adjuvant therapy after mitomycin for most women with stage II breast cancer, according to a report in the November issue of Clinical Drug Investigations. However, this relatively mild chemotherapy does not seem to prevent recurrence in high-risk patients.

Individually, tamoxifen, the combination of tegafur and uracil, and mitomycin have proven effective in improving survival rates among women with early stage breast cancer, the authors explainDr. Masami Ogita from National Sapporo Hospital, Sapporo, Japan and colleagues in the Adjuvant Chemoendocrine Therapy for Breast Cancer (ACETBC) Study Group evaluated combination therapy consisting of tegafur, uracil, and tamoxifen as postoperative adjuvant therapy for breast cancer with induction therapy with mitomycin in 753 women with stage II breast cancer (436 estrogen-receptor-positive and 317 estrogen-receptor-negative). Among women with estrogen-receptor-positive breast cancer, the addition of tegafur-uracil to tamoxifen improved 5-year disease-free survival from 83.1% to 90.7%, the authors report. Overall survival did not differ between the two treatments. Among women with estrogen-receptor-negative breast cancer, there was a trend toward better 5-year disease-free survival when tamoxifen was added to tegafur-uracil, the report indicates, but overall survival did not differ. Adverse reactions were more common with triple drug therapy than with tamoxifen alone in women with estrogen-receptor-positive breast cancer, the researchers note, but the addition of tamoxifen to tegafur-uracil did not increase the adverse reaction rate in women with estrogen-receptor-negative breast cancer. “Thus,” the authors conclude, “the addition of tegafur-uracil to tamoxifen in the postoperative setting might be a treatment option for breast cancer patients with relatively better prognosis factors, such as being postmenopausal and having a low number of lymph node metastases, although this type of mild chemotherapy does not seem to have enough efficacy to prevent recurrence of breast cancer in patients with poor prognostic factors such as being premenopausal and having a high number of lymph node metastases.”In addition, the investigators write, “no significant combined effect of tamoxifen plus tegafur-uracil plus mitomycin has been demonstrated in patients with estrogen-receptor-negative breast cancer, but the results indicate that postmenopausal patients and patients with negative lymph node metastases may benefit from additional tamoxifen in terms of prolongation of their disease-free survival.” (Source: Clin Drug Invest 2003;23:689-699: Reuters Health: December 4, 2003: Oncolink)