Breast Cancer Not Helped by Bone Marrow Transplant

By Gene Emery

BOSTON (Reuters) - Bone marrow transplant is ineffective when breast cancer has spread to other organs in the body, according to a nationwide study published on Friday by the New England Journal of Medicine.

The research originally was 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, Dr. Edward Stadtmauer, the study's 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 were 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 publish his results now because a report examining the discredited South African study is expected to be released soon.

In an editorial comment, also released on Friday by the Journal, Dr. Marc Lippman of the Lombardi Cancer Center in Washington, D.C., said doctors ``should now acknowledge that to a reasonable degree of probability this form of treatment for women with metastatic breast cancer has been proved to be ineffective and should be abandoned in favor of well-justified alternative experimental approaches.''

Stadtmauer said although the results showed that bone marrow transplants do not work for metastatic breast cancer, the case is not closed on whether the treatment might help women whose cancer has spread only to the adjacent lymph nodes.

For those women, preliminary indications suggested that the treatment offered no benefit at the three-year mark, he said, but researchers were still accumulating data on whether more transplant recipients were alive five years after therapy.

Aetna has said it is continuing to pay for bone marrow transplants if a breast cancer patient is enrolled in a federal research study.