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Long-Term Follow-Up of the Anthracyclines in Early Breast Cancer Trials (USOR 06-090, NSABP B-46-I/USOR 07132, and NSABP B-49 [NRG Oncology])

  • 0NSABP Foundation/NRG Oncology, Pittsburgh, PA.
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology +

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February 9, 2024

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February 9, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Anthracycline-based regimens were not found to be noninferior to nonanthracycline therapies in early breast cancer. Final analyses confirmed original findings, with anthracyclines favoring hormone receptor-negative patients but associated with increased late leukemias.

Area Of Science

  • Oncology
  • Clinical Trials
  • Breast Cancer Research

Background

  • Early breast cancer adjuvant therapy aims to prevent recurrence and improve survival.
  • Anthracycline-based regimens have been a standard but carry toxicity concerns.
  • Nonanthracycline regimens were investigated as potentially less toxic alternatives.

Purpose Of The Study

  • To report final efficacy analyses of the Anthracyclines in Early Breast Cancer (ABC) trials with long-term follow-up.
  • To compare anthracycline-based versus nonanthracycline adjuvant therapies in high-risk, early breast cancer.
  • To evaluate invasive disease-free survival (IDFS) and recurrence-free interval (RFI).

Main Methods

  • Joint final efficacy analyses of the ABC trials with 6.9 years of median follow-up.
  • Comparison of nonanthracycline versus anthracycline adjuvant therapy in early breast cancer.
  • Assessment of IDFS as the primary end point and RFI as a secondary end point.

Main Results

  • Long-term IDFS remained consistent with initial reports; noninferiority of nonanthracycline regimens was not demonstrated.
  • RFI favored anthracycline-based regimens, particularly in hormone receptor-negative cohorts (P = .02).
  • Overall survival showed no difference; anthracycline benefits in recurrence were offset by late leukemias and non-breast cancer deaths.

Conclusions

  • Anthracycline-based adjuvant therapy remains a viable option for high-risk early breast cancer, especially for hormone receptor-negative disease.
  • Nonanthracycline regimens did not prove noninferior to anthracyclines in the ABC trials.
  • Long-term follow-up highlights the trade-off between recurrence reduction and risks like late-onset leukemia with anthracyclines.