Introduction: Taxanes have demonstrated high activity in the treatment of metastatic breast cancer. Based on these promising results, clinical trials were initiated to assess their efficacy in non-metastatic breast cancer both in the adjuvant and neoadjuvant setting.
Objective: To collect scientific evidence as needed for future decision making on the use of taxanes in the adjuvant therapy of breast cancer with positive nodes, and to assess the efficacy of chemotherapy regimens including a taxane using a meta-analysis.
Search strategy: a systematic search of randomized controlled phase-Ill trials comparing poly-chemotherapy with taxanes versus other drug combinations with-out taxanes was performed. Patients were to have non-metastatic breast cancer with positive nodes, and should have received chemotherapy following surgery. The search was performed by two investigators separately.
Data collection and analysis: data(relapses and mortality) were separately collected from clinical tri-als by two investigators to assess disease-free survival and overall survival at 5 years. Selected data underwent a meta-analysis using Peto's method. Peto odds ratio (ORp) and 95% confidence interval were calculated for each measured variable.
Results: Only 3 clinical trials met inclusion criteria; 7,671 patients were studied. Combined OR was ORp 0.79 (95% Cl:0.71-0.87) for disease-free survival and OR, 0.82 (95% Cl: 0.73-0.92) for overall survival.
Conclusions: Chemotherapy regimens including a taxane in the adjuvant therapy setting for breast cancer with positive nodes provide a significant improvement regarding increased disease-free survival and overall survival at 5 years.