Early breast cancer patients benefit more from longer course chemotherapy: a matched-pair analysis

Aim: Benefit of longer course of taxane-anthracycline-based adjuvant chemotherapy is yet to be identified. Patients & methods: We conducted a retrospectively matched-pair analysis to compare four cycles of fluorouracil, epirubicin and cyclophosphamide followed by four cycles of docetaxel (4FEC-4T) with three cycles of FEC followed by three cycles of docetaxel (3FEC-3T) as adjuvant chemotherapy for early-stage breast cancer. One hundred and thirty-seven patients treated with 4FEC-4T were matched to 411 in 3FEC-3T. The primary end point was event-free survival (EFS). The secondary end point was distant disease-free survival (DDFS). Results: The 4FEC-4T resulted in significantly longer EFS than matched 3FEC-3T (p = 0.020). Furthermore, DDFS was superior in the 4FEC-4T to that in the 3FEC-3T (p = 0.046). Conclusion: Extending taxane-anthracycline-based regimens with identical schedules significantly improves EFS and DDFS for early-stage breast cancer.