© 2001 by Oxford University Press
Journal of the National Cancer Institute, Vol. 93, No. 23, 1761,
December 5, 2001
© 2001 Oxford University Press
MEMORANDUM FOR: Science Writers and Editors on the Journal Press List
Paclitaxel Related to Increased Risk of Lung Inflammation in Women Receiving Radiation for Breast Cancer
November 29, 2001 (EMBARGOED FOR RELEASE 4 P.M. EST December 4)
Adding paclitaxel to standard chemotherapy greatly increases the risk that women also receiving radiation treatment for breast cancer will develop pneumonitis (inflammation) of the lungs.
A common course of treatment for breast cancer with positive lymph nodes is surgery followed by sequential or concurrent chemotherapy and radiation therapy. Paclitaxel is often added to the standard chemotherapy treatment, although whether it improves the outcome is not known. In addition, paclitaxel may enhance the effectiveness of radiation therapy. In a study conducted by Alphonse G. Taghian, M.D., Ph.D., and colleagues at the Massachusetts General Hospital, Harvard Medical School, breast cancer patients who had paclitaxel added to chemotherapy were much more likely to develop radiation-induced pneumonitis than women receiving standard chemotherapy without paclitaxel. These results appear in the December 5 Journal of the National Cancer Institute.
In this study, 41 women were treated with radiation therapy and standard chemotherapy plus paclitaxel. Six of these patients developed radiation pneumonitis, a rate of 14.6%. The six patients who developed radiation pneumonitis had breathing difficulties, X-ray evidence of acute pneumonitis, and a severe dry cough that was unresponsive to narcotic anticough agents. Five women required treatment with steroids, and all of them recovered completely.
The rate of radiation pneumonitis in the 849 patients who received radiation therapy alone was 1.1%. This rate did not increase in the 437 patients who received radiation therapy and chemotherapy without paclitaxel. The difference between the crude rates of 14.6% with paclitaxel and 1.1% without it is highly statistically significant.
The mean time from the end of radiation to the development of pneumonitis in patients in the non-paclitaxel group was 5 months (range = 10 days to 17 months), compared with 1.9 months (range = 1 week to 4 months) in the paclitaxel group.
The authors conclude that their data suggest that paclitaxel increases the toxicity of radiation to the lung. Therefore, they say, in the absence of a clear benefit from adding paclitaxel to standard chemotherapy, the use of paclitaxel and radiation therapy in the primary treatment of breast cancer should be undertaken with caution. Furthermore, clinical trials using chemotherapy including paclitaxel plus radiation therapy, whether concurrent or sequential, must evaluate carefully the incidence of radiation pneumonitis.
Contact: Sue McGreevey, Massachusetts General Hospital, (617) 724-2764; fax: (617) 726-7475; smcgreevey{at}partners.org.
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Taghian AG, Assaad SI, Niemierko A, Kuter I, Younger J, Schoenthaler R, Roche M, Powell SN. Risk of pneumonitis in breast cancer patients treated with radiation therapy and combination chemotherapy with paclitaxel. J Natl Cancer Inst 2001;93:1806–11.
Note: This memo to reporters is from the Journal staff and is not an official release of the National Cancer Institute (NCI) or Oxford University Press (OUP) nor does it reflect NCI or OUP policy. In addition, unless otherwise stated, all articles and items published in the Journal reflect the individual views of the authors and not necessarily the official points of view held by NCI, any other component of the U.S. government, OUP, or the organizations with which the authors are affiliated. Neither NCI nor any other component of the U.S. government nor OUP assumes any responsibility for the completeness of the articles or other items or the accuracy of the conclusions reached therein.
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