Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

2092 - Should anthracyclines always be present in the adjuvant treatment of breast cancer (BC)? A systematic review and meta-analysis of randomized controlled trials (RCTs)

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Presenters

Rafael Caparica

Citation

Annals of Oncology (2018) 29 (suppl_8): viii58-viii86. 10.1093/annonc/mdy270

Authors

R. Caparica1, M. Bruzzone2, F. Poggio1, M. Ceppi2, E. de Azambuja3, M. Lambertini1

Author affiliations

  • 1 Ctsu, Institute Jules Bordet, 1000 - Brussels/BE
  • 2 Biostatistics, IRCCS AOU San Martino - IST-Istituto Nazionale per la Ricerca sul Cancro, 16132 - Genova/IT
  • 3 Medical Oncology, Institute Jules Bordet, 1000 - Brussels/BE
More

Resources

Abstract 2092

Background

Anthracycline and taxane-based (A+T) chemotherapy (CT) is the current standard adjuvant CT for HER2-negative BC patients. However, anthracyclines can be associated with important short and long-term toxicities (e.g. cardiotoxicity and leukemias). After a phase 3 trial demonstrated that docetaxel+cyclophosphamide (TC) was more effective than doxorubicin + cyclophosphamide (AC), the use of TC has increased. Nevertheless, RCTs could not demonstrate that TC is non-inferior to the standard A+T. This is a systematic review and meta-analysis of RCTs comparing A+T versus TC as adjuvant CT in HER2-negative BC patients.

Methods

A literature search using PubMed, EMBASE, Cochrane, ASCO, ESMO and SABCS websites was performed up to March 30, 2018, to identify RCTs comparing TC vs A+T as adjuvant CT in HER2-negative BC patients. Disease-free survival (DFS) and overall survival (OS) were assessed. A subgroup analysis of DFS in hormone receptor positive (HR+) and negative (HR-) disease was also performed. Hazard ratios (HR) and 95% confidence intervals (CI) for DFS were extracted from each trial, and a pooled analysis was conducted using the random-effect model. The Higgins' I-Squared Test was used to quantify heterogeneity.

Results

A total of 8 RCTs that randomized 12,741 early BC patients were included. Five RCTs were published as pooled results: ABC trials comprised 3 RCTs, and PlanB + Success-C comprised 2 RCTs. The comparison of TC versus A+T demonstrated a non-significant benefit in favour of A+T for both DFS (HR 1.08, 95% CI 0.96 - 1.20) and OS (HR 1.05; 95%CI 0.90 – 1.22). The magnitude of the benefit of A+T was more pronounced in patients with HR- disease, (N = 1,947, HR 1.12, 95% CI 0.93 – 1.34) compared to those with HR+ disease (N = 4,867, HR 1.05, 95%CI 0.86 – 1.27).

Conclusions

Globally, our results showed that A+T was associated with a slight non-significant improvement in DFS and OS as compared to TC. Nevertheless, in selected patients such as those with HR+ disease, TC may be considered an alternative option to avoid the toxicities of anthracycline-based CT.

Clinical trial identification

CRD42018090962 - PROSPERO register.

Legal entity responsible for the study

Institut Jules Bordet.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.