Doxorubicin/cyclophosphamide with concurrent versus sequential docetaxel as neoadjuvant treatment in patients with breast cancer.
until further notice
SourceEuropean Journal of Cancer, 49, 15, (2013), pp. 3102-3110
Article / Letter to editor
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Primary and Community Care
European Journal of Cancer
SubjectN4i 2: Invasive mycoses and compromised host ONCOL 3: Translational research; NCEBP 2:Evaluation of complex medical interventions ONCOL 4:Quality of Care; NCEBP 4: Quality of hospital and integrated care; NCEBP 4: Quality of hospital and integrated care ONCOL 4: Quality of Care; NCEBP 6: Quality of nursing and allied health care; NCEBP 7: Effective primary care and public health; ONCOL 3: Translational research NCMLS 3: Tissue engineering and pathology; ONCOL 4: Quality of Care NCEBP 4: Quality of hospital and integrated care; ONCOL 5: Aetiology, screening and detection; NCEBP 6: Quality of nursing and allied health care; ONCOL 3: Translational research NCMLS 3: Tissue engineering and pathology
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 100mg/m(2)) or six cycles of TAC (75/50/500mg/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. Copyright © 2013 Elsevier Ltd. All rights reserved. KEYWORDS: Breast cancer, Cyclophosphamide, Docetaxel, Doxorubicin, Neoadjuvant chemotherapy
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