Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Adjuvant Chemotherapy for Early-Stage Breast Ca

Which regimen is most effective?

For women with early-stage breast cancer, sequential anthracycline-cyclophosphamide and taxane (AC-T) is likely to be the most effective adjuvant therapy regimen in terms of overall survival (OS) regardless of hormone receptor status, according to a meta-analysis of 24 randomized trials. These trials compared 2 or more of the following: no adjuvant chemotherapy; sequential AC-T; concurrent anthracycline-cyclophosphamide and taxane (ACT); anthracycline-cyclophosphamide without taxane (AC); docetaxel and cyclophosphamide (TC); cyclophosphamide, methotrexate, and fluorouracil (CMF); and platinum-containing regimens. Researchers found:

• The TC and platinum-containing regimens had OS benefit similar to that of sequential AC-T (TC HR, 0.93; platinum HR, 0.93).

• Patients treated with CMF or AC had significantly worse OS than those treated with sequential AC-T. (CMF HR, 1.56; AC HR, 1.22).

• Platinum-containing regimens tended to be more toxic than sequential AC-T.

Citation: Fujii T, Le Du F, Xiao L, et al. Effectiveness of an adjuvant chemotherapy regimen for early-stage breast cancer. JAMA Oncol. [Published online ahead of print September 24, 2015]. doi: 10.1001/jamaoncol.2015.3062.