Some Breast Cancer Chemo Drugs More Beneficial To Big Pharma Than To Patients

In the most recent Breast Cancer Action newsletter, BCA Executive Director Barbara Brenner notes that,

“A double standard seems to be operating that means far too many people are getting treatments that are not only very aggressive, but are also unnecessary and of no benefit. The double standard has to do with how little evidence is needed to bring a new treatment into regular use versus how much evidence is needed to stop a treatment once it’s been shown to be ineffective in a group of patients.”

By way of example, Brenner points to the use of the commonly used anthracyline Adriamycin (generic name doxorubicin) despite the fact that,

“For several years, Dennis Slamon, the person credited with the development of Herceptin, has been reporting on research that shows that women whose breast tumors overexpress the Her2/neu protein (HER2-positive) benefit from anthracyclines, but those whose breast tumors are HER2-negative do not. As Ralph Moss reported in his Cancer Decisions Newsletter in July 2007, a number of studies now support this conclusion and lead inevitably to the observation that women who do not overexpress Her2/neu (and an additional gene known as Topoll-2–topoisomerase II alpha) should not receive anthracyline treatment, because they won’t derive any benefit from the drug.“

Then there is Taxol, that continues to be widely prescribed although “fewer than 20 percent of women with breast cancer have benefited from adding Taxol to adjuvant chemotherapy.”

BCA also reports that,

“The Food and Drug Administration (FDA) announced in January that it is reviewing two new studies that provide further evidence that the anemia drugs known as erythropoiesis-stimulating agents (ESAs) could be dangerous to breast cancer patients who receive them for treatment of chemotherapy-induced anemia.

The studies showed that patients with breast or advanced cervical cancers who received Aranesp, Epogen, or Procrit died sooner or had more rapid tumor growth than similar patients who did not receive the anemia drugs.“

So why do doctors continue to prescribe these drugs even when their benefit is nil, and they may in fact be harmful? As Brenner observes,

“Why does it take so little to add an aggressive therapy to treatment, but so much to remove one when evidence shows that it’s not working? I think there are two reasons. One is that U.S. doctors in particular have been trained (as have many patients) to believe that hitting cancer as quickly and with as much treatment as possible is going to be more successful in saving lives than a less aggressive approach. Given this training, doctors probably fear giving up on a treatment that they think might help some patients. Making a mistake could have big consequences if it turns out that the indications for nontreatment are wrong, or if a patient has a recurrence that might not have happened with treatment and sues for malpractice.

The other is that there is a huge investment in these drugs, and a lot of money being made in producing and administering them. Financial interests stand in the way of many changes. They create a large ship that is very hard to turn in a new direction.”