Doxorubicin/cyclophosphamide with concurrent versus sequential docetaxel as neoadjuvant treatment in patients with breast cancer

B. E. P. J. Vriens, M. J. B. Aarts, B. de Vries, S. M. van Gastel, J. Wals, T. J. Smilde, L. J. C. van Warmerdam, M. de Boer, D. J. van Spronsen, G. F. Borm, V. C. G. Tjan-Heijnen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

27 Citations (Web of Science)

Abstract

Background: This study was designed to determine whether delivering neo-adjuvant chemotherapy at a higher dose in a shorter period of time improves outcome of breast cancer patients. Patients and methods: Women with newly diagnosed breast cancer were randomly assigned to neoadjuvant chemotherapy of four cycles of doxorubicin and cyclophosphamide followed by four cycles of docetaxel (AC 60/600 T 100 mg/m(2)) or six cycles of TAC (75/50/500 mg/m(2)) every 3 weeks. The primary endpoint was the pathologic complete response (pCR) rate, defined as no invasive tumour present in the breast. Results: In total, 201 patients were included. Baseline characteristics were well balanced. AC-T resulted in pCR in 21% and TAC in 16% of patients (odds ratio 1.44 (95% confidence interval (CI) 0.67-3.10). AC-T without primary granulocyte-colony stimulating factor (G-CSF) prophylaxis was associated with more febrile neutropenia compared to TAC with primary G-CSF prophylaxis (23% versus 9%), and with more grade 3/4 sensory neuropathy (5% versus 0%). Conclusions: With a higher cumulative dose for the concurrent arm, no differences were observed between the two treatment arms with respect to pCR rate. The differential toxicity profile could partly be explained by different use of primary G-CSF prophylaxis.
Original languageEnglish
Pages (from-to)3102-3110
JournalEuropean Journal of Cancer
Volume49
Issue number15
DOIs
Publication statusPublished - Oct 2013

Keywords

  • Breast cancer
  • Cyclophosphamide
  • Docetaxel
  • Doxorubicin
  • Neoadjuvant chemotherapy

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