What is the clinical benefit of anthracycline treatment in early breast cancer?

This study investigated the benefit of anthracyclines (ATCs) in early breast cancer. They found that this treatment was an effective treatment in patients with early breast cancer. 

Breast cancer (BC) is one of the most common cancers. Early BC is usually treated with surgery to remove the tumor. Patients with early BC also undergo chemotherapy (CT) after surgery (adjuvant). This reduces the risk of disease recurrence. One type of CT drugs are anthracyclines (ATCs). ATCs kill cancer cells by blocking an enzyme inside them. 

ATCs also have negative side effects. ATCs can cause heart damage. Some studies suggest that CT regimens after surgery with non-ATC drugs are just as effective as ATC regimens. Some studies suggest the opposite. It is unclear if ATC or non-ATC regimens have better clinical benefit in early BC. 

This study analyzed data from 7 clinical trials. A total of 14,451 women were included in the analysis. Participants were on an ATC or non-ATC regimen. Follow-up was performed over a range of approximately 2-6 years. The authors compared the outcomes and treatment regimens. 

ATC regimens were associated with a 14% higher disease-free survival (DFS; survival without signs of cancer) and a 15% higher overall survival (OS) compared to non-ATC. Both ATC and non-ATC regimens were effective at improving DFS and OS.

Premenopausal patients had better DFS after non-ATC treatment. Postmenopausal patients had better DFS after ATC treatment. Side effects were similar in both regimens. Vomiting and fatigue were higher in ATC-treated patients. Low white blood cell count was also more common in ATC-treated patients. Heart side effects were low (0.1%) in the 7 trials analyzed for both treatments.  

The authors concluded that ATC was an effective treatment in early BC. 

The number of studies in this analysis was low. Some information was not available. The clinical benefit of ATC regimens may be greater in certain types of BC.