Breast cancer: dose reduction tied to poorer survival with adjuvant FEC-D

  • Veitch Z & al.
  • J Natl Compr Canc Netw
  • 1 Aug 2019

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

  • Total cumulative dose (TCD) of anthracycline/taxane-based chemotherapy shortens survival by about 50% relative to doses of ≥85% in women with early breast cancer.
  • Early dose cuts largely accounted for the effect.

Why this matters

  • This is the first study to determine survival effect of cutting doses with third-generation chemotherapy.
  • A similar association was previously established with first- and second-generation adjuvant chemotherapy.

Study design

  • Retrospective cohort of 1302 Canadian patients with early breast cancer (HR-positive/negative, HER2-negative).
  • TCD for adjuvant 5-fluorouracil/epirubicin/cyclophosphamide followed by docetaxel (FEC-D) was calculated for 6 cycles.
  • Early (FEC±D) was compared with late (D only) dose reductions.
  • Funding: None declared.

Key results

  • Only 16% of the cohort had TCD
  • In multivariate analysis, TCD

  • Early cumulative dose reductions (FEC±D
  • Late cumulative dose reductions (FEC±D=100% cycles 1-3; D

Limitations

  • Observational design.