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    Long-term outcomes after adjuvant treatment of sequential versus combination docetaxel with doxorubicin and cyclophosphamide in node-positive breast cancer: BCIRG-005 randomized trial.

    Access Status
    Open access via publisher
    Authors
    Mackey, J.
    Pienkowski, T.
    Crown, J.
    Sadeghi, S.
    Martin, M.
    Chan, Arlene
    Saleh, M.
    Sehdev, S.
    Provencher, L.
    Semiglazov, V.
    Press, M.
    Sauter, G.
    Lindsay, M.
    Houé, V.
    Buyse, M.
    Drevot, P.
    Hitier, S.
    Bensfia, S.
    Eiermann, W.
    Translational Research In Oncology (TRIO)/ Breast Cancer International Research Group (BCIRG)-005 in
    Date
    2016
    Type
    Journal Article
    
    Metadata
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    Citation
    Mackey, J. and Pienkowski, T. and Crown, J. and Sadeghi, S. and Martin, M. and Chan, A. and Saleh, M. et al. 2016. Long-term outcomes after adjuvant treatment of sequential versus combination docetaxel with doxorubicin and cyclophosphamide in node-positive breast cancer: BCIRG-005 randomized trial.. Annals of Oncology. 27 (6): pp. 1041-1047.
    Source Title
    Annals of Oncology
    DOI
    10.1093/annonc/mdw098
    ISSN
    1569-8041
    School
    Curtin Medical School
    URI
    http://hdl.handle.net/20.500.11937/58543
    Collection
    • Curtin Research Publications
    Abstract

    BACKGROUND: The optimal regimen for adjuvant breast cancer chemotherapy is undefined. We compared sequential to concurrent combination of doxorubicin and cyclophosphamide with docetaxel chemotherapy in women with node-positive non-metastatic breast cancer. We report the final, 10-year analysis of disease-free survival (DFS), overall survival (OS), and long-term safety. PATIENTS AND METHODS: A total of 3298 women with HER2 nonamplified breast cancer were randomized to doxorubicin and cyclophosphamide every 3 weeks for four cycles followed by docetaxel (AC ? T) every 3 weeks for four cycles or docetaxel, doxorubicin, and cyclophosphamide (TAC) every 3 weeks for six cycles. The patients received standard radiotherapy and endocrine therapy and were followed up for 10 years with annual clinical evaluation and mammography. RESULTS: The 10-year DFS rates were 66.5% in the AC ? T arm and 66.3% in the TAC arm (P = 0.749). OS was 79.9% in the AC ? T arm and 78.9% in the TAC arm (P = 0.506). TAC was associated with higher rates of febrile neutropenia, although G-CSF primary prophylaxis greatly reduced this risk. AC ? T was associated with a higher rate of myalgia, hand-foot syndrome, fluid retention, and sensory neuropathy. CONCLUSION: This 10-year analysis of the BCIRG-005 trial confirmed that the efficacy of TAC was not superior to AC ? T in women with node-positive early breast cancer. The toxicity profiles differ between arms and were consistent with previous reports. The TAC regimen with G-CSF support provides shorter adjuvant treatment duration with less toxicity. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT00312208.

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