Comparing the effectiveness of epirubicin and cyclophosphamide plus taxanes versus carboplatin plus taxanes in early-stage triple‑negative breast cancer.

This study compared the effectiveness of epirubicin (Ellence) and cyclophosphamide (Cytoxan) plus paclitaxel (Taxol)/docetaxel (Taxotere) (taxanes) (ECT) versus carboplatin (Paraplatin) plus taxanes (TP) regimens in patients with early-stage triple-negative breast cancer (TNBC). The data showed that both treatment regimens showed similar survival outcomes in patients with early-stage TNBC.

TNBC is a subtype of BC that tests negative for female hormone receptors (estrogen and/or progesterone) and the HER2 protein. TNBC accounts for 10-15% of all BCs. It is associated with a poorer disease outcome compared to other subtypes of BC. Treatments for TNBC usually involve a combination of surgery, chemotherapy, and radiotherapy.

Adjuvant chemotherapy (ACT; treatment after surgery) is often used to destroy any remaining cancer cells and to prevent cancer recurrence. ECT regimen is an ACT that has been shown to improve the survival of patients with early-stage TNBC. However, epirubicin increases the risk of heart-related side effects and some older patients may have to stop epirubicin-based chemotherapy. Therefore, new alternative therapies must be used.

Platinum-based agents such as carboplatin are chemotherapy drugs that damage the DNA in cancer cells, causing the cells to die. However, the effectiveness of ECT versus TP regimens for the treatment of patients with early-stage TNBC is still unknown.

This study involved 308 patients with TNBC. Patients were randomly assigned into 2 groups. Group 1 included 154 patients who received the ECT regimen every 3 weeks. Group 2 included 154 patients who received the TP regimen every 3 weeks. The average follow-up time was 97.6 months.

The average disease-free survival (DFS) and overall survival (OS) rates were not reached (exceeded the average follow-up period). After 8 years, 87.2% of the patients in group 1 were alive compared to 89.1% of the patients in group 2. After 8 years, 78.4% of the patients in group 1 were alive and disease-free compared to 81.7% of the patients in group 2.

Overall, a similar number of patients in both groups experienced side effects. The most common side effects were low counts of white blood cells, hair loss, and loss of appetite.

This study concluded that both treatment regimens showed similar survival outcomes in patients with early-stage TNBC. The authors suggest that TP might be an effective alternative chemotherapy for patients in whom the standard ECT regimen is not being used.

This study did not directly compare between 3-week TP chemotherapy and intensive epirubicin and cyclophosphamide followed by weekly paclitaxel chemotherapy. Both docetaxel and paclitaxel were used in TP or ECT regimen.