Adjuvant breast cancer: data favor cyclophosphamide-free taxane+anthracycline

  • Breast Cancer Res Treat
  • 9 Apr 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Adding cyclophosphamide to adjuvant taxane+anthracycline (TA) chemotherapy failed to boost 70-month survival outcomes and was associated with increased toxicity in a study of women with node-positive early breast cancer.

Why this matters

  • Adjuvant taxane+anthracycline+cyclophosphamide (TAC) is the current standard of care, but may be supplanted by TA if results stand up in future assessments.

Study design

  • Randomized controlled trial of 640 women with stage pT1-4N1-3M0 breast cancer, aged 18-70 years.
  • TA composed of intravenous epirubicin 75 mg/m2 plus docetaxel 75 mg/m2 every 21 days; for TAC, 500 mg/m2 intravenous cyclophosphamide was added.
  • QoL evaluated via Chinese translation of the European Organization for Research and Treatment in Cancer Quality of Life Questionnaire (EORTC QLQ-C30), with higher score indicating better QoL.
  • Funding: None.

Key results

  • At median of 70 months, there was no difference between TA and TAC with respect to:
    • Median disease-free survival: 79.7% vs 75.6% (P=.371).
    • Median OS: 85.1% vs 87.6% (P=.271).
  • TA was associated with fewer grade 3/4 toxicities than TAC:
    • Vomiting: 11.7% vs 18.1% (P=.025).
    • Nausea:13.0% vs 19.4% (P=.031).
  • QoL was better with TA vs TAC (74.11±5.250 vs 67.92±4.449; P=.001).

Limitations

  • Open-label design.
  • Hormone-receptor status unknown.

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