KEY TAKEAWAYS
- The study aimed to compare the efficacy and cardiotoxicity of adjuvant TC vs anthracycline-taxane in stages I-III, HER2-negative BC.
- Researchers found no significant differences in DFS, OS, or cardiotoxicity, with anthracycline-taxane reducing relapse in women with ≥4 nodes.
Anthracycline-taxane is the standard chemotherapy strategy for treating high-risk early breast cancer (BC) despite the potentially life-threatening adverse events associated with anthracyclines. As an alternative, the combination of docetaxel and cyclophosphamide (TC) is often considered, though its efficacy compared to anthracycline-taxane chemotherapy remains unclear.
Danilo Giffoni de Mello Morais Mata and the team aimed to compare disease-free survival (DFS), overall survival (OS), and cardiotoxicity outcomes between adjuvant TC and anthracycline-taxane chemotherapy in women with stages I-III, HER2-negative BC.
They performed an inclusive analysis by conducting a systematic search on MEDLINE, Embase, and Cochrane CENTRAL for randomized-controlled trials published up to 11 March 2024. This comprehensive search yielded 203 studies involving 11,803 patients, of which 7 trials met the criteria for inclusion.
The selected studies were carefully evaluated to compare DFS, OS, and cardiotoxicity outcomes between adjuvant TC and anthracycline-taxane chemotherapy in women with stages I-III, and HER2-negative BC.
About the results, TC showed little to no difference compared to anthracycline-taxane in DFS (HR 1.09, 95% CI 0.98-1.20; moderate-certainty of evidence), OS (HR 1.02, 95% CI 0.89-1.16; high-certainty of evidence), and cardiotoxicity (RR 0.54, 95% CI 0.16-1.76; high-certainty of evidence). However, in the subgroup analysis, patients with ≥4 lymph nodes demonstrated improved DFS with anthracycline-taxane compared to TC.
The study concluded that there was no significant difference between TC and anthracycline-taxane in terms of DFS, OS, and cardiotoxicity. However, in women with ≥4 lymph nodes, anthracycline-taxane was associated with a substantial reduction in relapse events compared to TC. The findings support the current standard of practice, indicating that both anthracycline-taxane and TC chemotherapy are reasonable options, with treatment selection tailored to individual patient cases.
This study received no external funding.
Source: https://pubmed.ncbi.nlm.nih.gov/39195318/
Giffoni de Mello Morais Mata D, Rush MB, Smith-Uffen M, et al. (2024). “The Omission of Anthracycline Chemotherapy in Women with Early HER2-Negative Breast Cancer-A Systematic Review and Meta-Analysis.” Curr Oncol. 2024;31(8):4486-4506. Published 2024 Aug 3. doi:10.3390/curroncol31080335
