By Gene Emery
BOSTON, March 3 (Reuters) - Bone marrow transplant is ineffective when breast
cancer has spread to other organs in the body, according to a nationwide study
released on Friday by the editors of the New England Journal of Medicine.
The research was originally scheduled to be published on April 13 but the
Journal decided to release it early because of its clinical significance.
Among women whose tumors had spread to other parts of the body, patients who
received high-dose chemotherapy and a bone marrow transplant as a last-ditch
treatment were no more likely to survive for three years than women who simply
received maintenance chemotherapy instead, Dr. Edward A. Stadtmauer, the chief
author, told Reuters.
"There is not a clear benefit to doing a transplant for metastatic breast
cancer," said Stadtmauer, director of the bone marrow transplant program at the
University of Pennsylvania Cancer Center in Philadelphia.
The results, based on 184 volunteers, were presented last May at a meeting
of the American Society of Clinical Oncology.
The findings are timely because Aetna U.S. Healthcare, a unit of Aetna Inc.
and the nation's largest health insurer, announced on Feb. 16 that it was ending
coverage for bone marrow transplants for women with breast cancer because
several studies, including Stadtmauer's, had shown that the treatment was
ineffective.
The one large study suggesting that the treatment worked, conducted in South
Africa, "was completely fabricated," Dr. Joseph Carver, senior medical director
at Aetna, said at the time.
Stadtmauer said the Journal may have wanted to release his results now
because a report examining the discredited South African study is expected to be
published in the next week or so.
Stadtmauer said although the results show that bone marrow transplants don't
work for metastatic breast cancer, the case isn't closed on whether the
treatment might help women whose cancer has only spread to the adjacent lymph
nodes.
For those women, preliminary indications suggest that the treatment offers
no benefit at the three-year mark, he said, but researchers are still
accumulating data on whether more transplant recipients are alive five years
after therapy.
Aetna has said is continuing to pay for bone marrow transplants if a breast
cancer patient is enrolled in a federal research study.
