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Erschienen in: Breast Cancer Research and Treatment 3/2019

01.04.2019 | Clinical trial

Efficacy and safety of taxane plus anthracycline with or without cyclophosphamide in Chinese node-positive breast cancer patients: an open-label, randomized controlled trial

verfasst von: Yan Lin, Changjun Wang, Xin Huang, Xingtong Zhou, Yidong Zhou, Feng Mao, Jinghong Guan, Yu Song, Ying Zhong, Ying Xu, Qiang Sun

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 3/2019

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Abstract

Purpose

To evaluate and compare the efficacy and safety of the taxane plus anthracycline (TA) regimen vs. the taxane plus anthracycline plus cyclophosphamide (TAC) regimen as adjuvant chemotherapy in Chinese patients with node-positive breast cancer (BCa).

Methods

Patients with BCa (n = 640) were recruited between January 2010 and June 2012. All patients were randomized to receive six cycles of adjuvant therapy with the TA or TAC regimen. The primary endpoint was disease-free survival (DFS). The secondary endpoints were overall survival (OS), quality of life (QoL), and chemotherapy-related toxicity. Finally, 630 patients were evaluable, with a median follow-up of 70 months.

Results

There were no differences in the 70-month median DFS and OS between the two groups (DFS: TA 79.7% vs. TAC 75.6%, P = 0.371; OS: TA vs. TAC, 85.1% vs. 87.6%, P = 0.271). The TA group had lower frequencies grade III/IV vomiting (TA vs. TAC, 11.7% vs. 18.1%, P = 0.025) and nausea (13.0% vs. 19.4%, P = 0.031). The health-related QoL score was higher in the TA group (74.1 ± 5.3 vs. 67.9 ± 4.4, P = 0.001 vs. TAC).

Conclusions

In the adjuvant setting, compared with the TAC regimen, the TA regimen exhibits no significant difference with respect to DFS and OS in Chinese patients with node-positive BCa. On the other hand, TA is associated with less severe adverse events, lower economic burden, and better QoL.
Literatur
2.
Zurück zum Zitat Schmidt M, Koelbl H (2012) Adjuvant chemotherapy in early breast cancer. Minerva Ginecol 64(1):53–65PubMed Schmidt M, Koelbl H (2012) Adjuvant chemotherapy in early breast cancer. Minerva Ginecol 64(1):53–65PubMed
3.
Zurück zum Zitat Nabholtz JM, Riva A (2001) Taxane/anthracycline combinations: setting a new standard in breast cancer? The Oncologist 6(Suppl 3):5–12CrossRefPubMed Nabholtz JM, Riva A (2001) Taxane/anthracycline combinations: setting a new standard in breast cancer? The Oncologist 6(Suppl 3):5–12CrossRefPubMed
5.
6.
Zurück zum Zitat NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Breast cancer. Version 4.2018 (2019). National Comprehensive Cancer Network, Fort Washington NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Breast cancer. Version 4.2018 (2019). National Comprehensive Cancer Network, Fort Washington
8.
Zurück zum Zitat Denduluri N, Somerfield MR, Eisen A, Holloway JN, Hurria A, King TA, Lyman GH, Partridge AH, Telli ML, Trudeau ME, Wolff AC (2016) Selection of optimal adjuvant chemotherapy regimens for human epidermal growth factor receptor 2 (HER2)-negative and adjuvant targeted therapy for HER2-positive breast cancers: an American Society of Clinical Oncology Guideline Adaptation of the Cancer Care Ontario Clinical Practice Guideline. J Clin Oncol 34(20):2416–2427. https://doi.org/10.1200/JCO.2016.67.0182 CrossRefPubMed Denduluri N, Somerfield MR, Eisen A, Holloway JN, Hurria A, King TA, Lyman GH, Partridge AH, Telli ML, Trudeau ME, Wolff AC (2016) Selection of optimal adjuvant chemotherapy regimens for human epidermal growth factor receptor 2 (HER2)-negative and adjuvant targeted therapy for HER2-positive breast cancers: an American Society of Clinical Oncology Guideline Adaptation of the Cancer Care Ontario Clinical Practice Guideline. J Clin Oncol 34(20):2416–2427. https://​doi.​org/​10.​1200/​JCO.​2016.​67.​0182 CrossRefPubMed
9.
Zurück zum Zitat Ganz P, Land S, Geyer C, Costantino J, Pajon E, Fehrenbacher L, Atkins J, Polikoff J, Vogel V (2008) Erban J NSABP B-30: definitive analysis of quality of life (QOL) and menstrual history outcomes from a randomized trial evaluating different women with operable, node-positive breast cancer. In: Presented at the 31st annual San Antonio Breast Cancer Symposium, December 10–14, 2008. Abstract Ganz P, Land S, Geyer C, Costantino J, Pajon E, Fehrenbacher L, Atkins J, Polikoff J, Vogel V (2008) Erban J NSABP B-30: definitive analysis of quality of life (QOL) and menstrual history outcomes from a randomized trial evaluating different women with operable, node-positive breast cancer. In: Presented at the 31st annual San Antonio Breast Cancer Symposium, December 10–14, 2008. Abstract
10.
Zurück zum Zitat Fernandez-Ortega P, Caloto MT, Chirveches E, Marquilles R, Francisco JS, Quesada A, Suarez C, Zorrilla I, Gomez J, Zabaleta P, Nocea G, Llombart-Cussac A (2012) Chemotherapy-induced nausea and vomiting in clinical practice: impact on patients’ quality of life. Support Care Cancer 20(12):3141–3148. https://doi.org/10.1007/s00520-012-1448-1 CrossRefPubMed Fernandez-Ortega P, Caloto MT, Chirveches E, Marquilles R, Francisco JS, Quesada A, Suarez C, Zorrilla I, Gomez J, Zabaleta P, Nocea G, Llombart-Cussac A (2012) Chemotherapy-induced nausea and vomiting in clinical practice: impact on patients’ quality of life. Support Care Cancer 20(12):3141–3148. https://​doi.​org/​10.​1007/​s00520-012-1448-1 CrossRefPubMed
11.
Zurück zum Zitat Grunberg SM (2009) Obstacles to the implementation of antiemetic guidelines. J Natl Compr Cancer Netw 7(5):601–605CrossRef Grunberg SM (2009) Obstacles to the implementation of antiemetic guidelines. J Natl Compr Cancer Netw 7(5):601–605CrossRef
13.
Zurück zum Zitat Roila F, Herrstedt J, Aapro M, Gralla RJ, Einhorn LH, Ballatori E, Bria E, Clark-Snow RA, Espersen BT, Feyer P, Grunberg SM, Hesketh PJ, Jordan K, Kris MG, Maranzano E, Molassiotis A, Morrow G, Olver I, Rapoport BL, Rittenberg C, Saito M, Tonato M, Warr D, Group EMGW (2010) Guideline update for MASCC and ESMO in the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: results of the Perugia consensus conference. Ann Oncol 21(Suppl 5):v232–v243. https://doi.org/10.1093/annonc/mdq194 CrossRef Roila F, Herrstedt J, Aapro M, Gralla RJ, Einhorn LH, Ballatori E, Bria E, Clark-Snow RA, Espersen BT, Feyer P, Grunberg SM, Hesketh PJ, Jordan K, Kris MG, Maranzano E, Molassiotis A, Morrow G, Olver I, Rapoport BL, Rittenberg C, Saito M, Tonato M, Warr D, Group EMGW (2010) Guideline update for MASCC and ESMO in the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: results of the Perugia consensus conference. Ann Oncol 21(Suppl 5):v232–v243. https://​doi.​org/​10.​1093/​annonc/​mdq194 CrossRef
14.
15.
Zurück zum Zitat Jacobs C, Hutton B, Mazzarello S, Smith S, Joy A, Amir E, Ibrahim MF, Gregario N, Daigle K, Eggert L, Clemons M (2015) Optimisation of steroid prophylaxis schedules in breast cancer patients receiving docetaxel chemotherapy-a survey of health care providers and patients. Support Care Cancer 23(11):3269–3275. https://doi.org/10.1007/s00520-015-2731-8 CrossRefPubMed Jacobs C, Hutton B, Mazzarello S, Smith S, Joy A, Amir E, Ibrahim MF, Gregario N, Daigle K, Eggert L, Clemons M (2015) Optimisation of steroid prophylaxis schedules in breast cancer patients receiving docetaxel chemotherapy-a survey of health care providers and patients. Support Care Cancer 23(11):3269–3275. https://​doi.​org/​10.​1007/​s00520-015-2731-8 CrossRefPubMed
16.
Zurück zum Zitat Smith TJ, Bohlke K, Lyman GH, Carson KR, Crawford J, Cross SJ, Goldberg JM, Khatcheressian JL, Leighl NB, Perkins CL, Somlo G, Wade JL, Wozniak AJ, Armitage JO, American Society of Clinical O (2015) Recommendations for the use of WBC growth factors: American Society of Clinical Oncology Clinical Practice Guideline update. J Clin Oncol 33(28):3199–3212. https://doi.org/10.1200/JCO.2015.62.3488 CrossRefPubMed Smith TJ, Bohlke K, Lyman GH, Carson KR, Crawford J, Cross SJ, Goldberg JM, Khatcheressian JL, Leighl NB, Perkins CL, Somlo G, Wade JL, Wozniak AJ, Armitage JO, American Society of Clinical O (2015) Recommendations for the use of WBC growth factors: American Society of Clinical Oncology Clinical Practice Guideline update. J Clin Oncol 33(28):3199–3212. https://​doi.​org/​10.​1200/​JCO.​2015.​62.​3488 CrossRefPubMed
23.
25.
26.
Zurück zum Zitat Ward S, Simpson E, Davis S, Hind D, Rees A, Wilkinson A (2007) Taxanes for the adjuvant treatment of early breast cancer: systematic review and economic evaluation. Health Technol Assess 11(40):1–144CrossRefPubMed Ward S, Simpson E, Davis S, Hind D, Rees A, Wilkinson A (2007) Taxanes for the adjuvant treatment of early breast cancer: systematic review and economic evaluation. Health Technol Assess 11(40):1–144CrossRefPubMed
28.
Zurück zum Zitat De Laurentiis M, Cancello G, D’Agostino D, Giuliano M, Giordano A, Montagna E, Lauria R, Forestieri V, Esposito A, Silvestro L, Pennacchio R, Criscitiello C, Montanino A, Limite G, Bianco AR, De Placido S (2008) Taxane-based combinations as adjuvant chemotherapy of early breast cancer: a meta-analysis of randomized trials. J Clin Oncol 26(1):44–53. https://doi.org/10.1200/JCO.2007.11.3787 CrossRefPubMed De Laurentiis M, Cancello G, D’Agostino D, Giuliano M, Giordano A, Montagna E, Lauria R, Forestieri V, Esposito A, Silvestro L, Pennacchio R, Criscitiello C, Montanino A, Limite G, Bianco AR, De Placido S (2008) Taxane-based combinations as adjuvant chemotherapy of early breast cancer: a meta-analysis of randomized trials. J Clin Oncol 26(1):44–53. https://​doi.​org/​10.​1200/​JCO.​2007.​11.​3787 CrossRefPubMed
29.
Zurück zum Zitat Sparano JA, Gray RJ, Makower DF, Pritchard KI, Albain KS, Hayes DF, Geyer CE Jr, Dees EC, Goetz MP, Olson JA Jr, Lively T, Badve SS, Saphner TJ, Wagner LI, Whelan TJ, Ellis MJ, Paik S, Wood WC, Ravdin PM, Keane MM, Gomez Moreno HL, Reddy PS, Goggins TF, Mayer IA, Brufsky AM, Toppmeyer DL, Kaklamani VG, Berenberg JL, Abrams J, Sledge GW, Jr. (2018) Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer. N Engl J Med 379(2):111–121. https://doi.org/10.1056/NEJMoa1804710 CrossRefPubMedPubMedCentral Sparano JA, Gray RJ, Makower DF, Pritchard KI, Albain KS, Hayes DF, Geyer CE Jr, Dees EC, Goetz MP, Olson JA Jr, Lively T, Badve SS, Saphner TJ, Wagner LI, Whelan TJ, Ellis MJ, Paik S, Wood WC, Ravdin PM, Keane MM, Gomez Moreno HL, Reddy PS, Goggins TF, Mayer IA, Brufsky AM, Toppmeyer DL, Kaklamani VG, Berenberg JL, Abrams J, Sledge GW, Jr. (2018) Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer. N Engl J Med 379(2):111–121. https://​doi.​org/​10.​1056/​NEJMoa1804710 CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Harbeck N, Gluz O, Christgen M, Kates RE, Braun M, Kuemmel S, Schumacher C, Potenberg J, Kraemer S, Kleine-Tebbe A, Augustin D, Aktas B, Forstbauer H, Tio J, von Schumann R, Liedtke C, Grischke EM, Schumacher J, Wuerstlein R, Kreipe HH, Nitz UA (2017) De-escalation strategies in human epidermal growth factor receptor 2 (HER2)-positive early breast cancer (BC): final analysis of the West German Study Group adjuvant dynamic marker-adjusted personalized therapy trial optimizing risk assessment and therapy response prediction in early BC HER2- and hormone receptor-positive phase II randomized trial-efficacy, safety, and predictive markers for 12 weeks of neoadjuvant trastuzumab emtansine with or without endocrine therapy (ET) versus trastuzumab plus ET. J Clin Oncol 35 (26):3046–3054. https://doi.org/10.1200/JCO.2016.71.9815 CrossRefPubMed Harbeck N, Gluz O, Christgen M, Kates RE, Braun M, Kuemmel S, Schumacher C, Potenberg J, Kraemer S, Kleine-Tebbe A, Augustin D, Aktas B, Forstbauer H, Tio J, von Schumann R, Liedtke C, Grischke EM, Schumacher J, Wuerstlein R, Kreipe HH, Nitz UA (2017) De-escalation strategies in human epidermal growth factor receptor 2 (HER2)-positive early breast cancer (BC): final analysis of the West German Study Group adjuvant dynamic marker-adjusted personalized therapy trial optimizing risk assessment and therapy response prediction in early BC HER2- and hormone receptor-positive phase II randomized trial-efficacy, safety, and predictive markers for 12 weeks of neoadjuvant trastuzumab emtansine with or without endocrine therapy (ET) versus trastuzumab plus ET. J Clin Oncol 35 (26):3046–3054. https://​doi.​org/​10.​1200/​JCO.​2016.​71.​9815 CrossRefPubMed
35.
Metadaten
Titel
Efficacy and safety of taxane plus anthracycline with or without cyclophosphamide in Chinese node-positive breast cancer patients: an open-label, randomized controlled trial
verfasst von
Yan Lin
Changjun Wang
Xin Huang
Xingtong Zhou
Yidong Zhou
Feng Mao
Jinghong Guan
Yu Song
Ying Zhong
Ying Xu
Qiang Sun
Publikationsdatum
01.04.2019
Verlag
Springer US
Erschienen in
Breast Cancer Research and Treatment / Ausgabe 3/2019
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-019-05207-x

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