Wednesday, June 2, 2010 (Last Updated: 06/03/2010)
WEDNESDAY, June 2 (HealthDay News) -- Doxorubicin and cyclophosphamide followed by docetaxel (sequential ACT) shows some survival benefit compared to doxorubicin-docetaxel or concurrent ACT in women with operable early breast cancer, according to research published in the June 3 issue of the New England Journal of Medicine.
Sandra M. Swain, M.D., of the Washington Cancer Institute in Washington, D.C., and colleagues analyzed data from 5,351 patients with node-positive disease who had undergone primary surgery and were randomized to receive four cycles of sequential ACT, four cycles of doxorubicin and docetaxel, or four cycles of concurrent ACT.
The researchers found that, over a median of 73 months, sequential ACT was significantly associated with improved disease-free survival compared to concurrent ACT or doxorubicin and docetaxel, as well as improved overall survival compared to doxorubicin and docetaxel. Regardless of the treatment or estrogen-receptor status, amenorrhea for six months or more was associated with improved survival.
"As discussed by the authors, it is hard to escape the conclusion that the inferior results associated with the 12-week regimens in this trial were mainly due to the significant dose reductions required to make the doxorubicin-docetaxel and concurrent-ACT regimens feasible," writes the author of an accompanying editorial. "An overall survival advantage of 4 percentage points is only a modest gain in exchange for increasing the dose of chemotherapy agents, doubling the duration of therapy, and markedly increasing acute toxicity."
The study was partly supported by Sanofi-Aventis. Several co-authors disclosed financial relationships with Sanofi-Aventis, as well as other pharmaceutical and medical device companies.
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