In a nutshell
This study compared the side effects and outcome of two drug regimens in women with high-risk node-positive breast cancer (BC). Both treatment regimens were found to have similar survival outcomes.
Standard treatment in node positive BC (cancer that has spread to the lymph nodes) consists of two categories of chemotherapy received in sequence; taxane-based and anthracycline-based. This combined therapy has shown significantly improved disease free survival (DFS; the length of time after cancer treatment that the patient remains without symptoms) and overall survival (OS; the time between the end of treatment and the death of a patient from any cause). EC-DOC consists of epirubicin (Ellence) and cyclophosphamide (Cytoxan) followed by docetaxel (Taxotere). FEC120 consists of 5-fluorouracil (Adrucil) with epirubicin and cyclophosphamide. The optimal treatment regimen for combining taxane-based and anthracycline based therapy is not yet known.
Methods & findings
This study involved 1364 women with invasive BC and lymph node involvement. The patients were randomly assigned to one of two groups: 689 were treated with EC-DOC and 675 were treated with FEC120. The average follow-up time was 60.6 months in the EC-DOC group and 59.5 months in FEC120 group.
DFS was similar between the two groups. DIsease progression occured in 26% of patients in the EC-DOC group and 23.1% of patients in FEC120 group after 5 years. 5-year OS was also similar between the two groups. 19.4% of each group died during the follow-up period.
FEC120 patients were found to be at greater risk of blood-based side effects such as anemia (low levels of hemoglobin, a type of red blood cell) than those in the EC-DOC group. EC-DOC patients were at greater risk of side effects such as vomiting and swelling than those in the FEC120 group. Serious side effects were significantly more common in the FEC120 group (29.7%) compared to the EC-DOC group (22.5%).
The bottom line
The study concluded that both treatment regimens had similar disease free and overall survival outcomes but different side effects.
The fine print
The study did not account for patients without lymph node involvement or elderly patients who were not included in the study group. The influence of HER-2 specific treatment was also not accounted for.
Consult with your physician about which treatment options are right for you.
Published By :
British Journal of Cancer
Mar 31, 2016
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