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Published on: February 12, 2017
Adjuvant docetaxel for node-positive breast cancer.
Miguel Martin1, Tadeusz Pienkowski, John Mackey
1Hospital Universitario San Carlos, Madrid, Spain. mmartin@geicam.org
The New England Journal of Medicine
|June 3, 2005
Summary
Docetaxel plus doxorubicin and cyclophosphamide (TAC) chemotherapy significantly improves disease-free and overall survival for operable node-positive breast cancer patients compared to fluorouracil plus doxorubicin and cyclophosphamide (FAC). TAC demonstrated a 28% reduction in relapse risk and a 30% reduction in mortality risk.
Area of Science:
- Oncology
- Clinical Trials
- Pharmacology
Background:
- Adjuvant chemotherapy is crucial for operable node-positive breast cancer.
- Comparing different chemotherapy regimens is essential for optimizing treatment outcomes.
Purpose of the Study:
- To compare the efficacy of docetaxel plus doxorubicin and cyclophosphamide (TAC) versus fluorouracil plus doxorubicin and cyclophosphamide (FAC) as adjuvant chemotherapy.
- To evaluate disease-free survival (DFS) and overall survival (OS) in patients with operable node-positive breast cancer.
Main Methods:
- A randomized trial involving 1491 women with axillary node-positive breast cancer.
- Patients received six cycles of either TAC or FAC adjuvant chemotherapy post-surgery.
- Disease-free survival was the primary endpoint.
Main Results:
- At 5-year follow-up, TAC showed a 75% DFS rate versus 68% for FAC, a 28% reduction in relapse risk (P=0.001).
- TAC demonstrated an 87% OS rate versus 81% for FAC, a 30% reduction in mortality risk (P=0.008).
- Higher rates of grade 3/4 neutropenia and febrile neutropenia were observed with TAC, but serious infections and treatment-related deaths were comparable.
Conclusions:
- Adjuvant TAC chemotherapy significantly improves disease-free and overall survival in operable node-positive breast cancer.
- TAC offers a survival benefit over FAC in this patient population.
- While TAC is associated with increased neutropenia, the survival benefits outweigh the risks for operable node-positive breast cancer.
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