Sequential versus concurrent anthracyclines and taxanes as adjuvant chemotherapy of early breast cancer: a meta-analysis of phase III randomized control trials

Breast. 2012 Jun;21(3):389-93. doi: 10.1016/j.breast.2012.03.011. Epub 2012 Apr 26.

Abstract

Purpose: We performed a meta-analysis of Phase III randomized trials to compare treatment outcomes for early-stage breast cancer patients receiving adjuvant chemotherapy with sequential or concurrent anthracyclines and taxanes.

Methods: All Phase III randomized trials comparing adjuvant chemotherapy of sequential or concurrent anthracyclines and taxanes in early-stage breast cancer patients were considered eligible. A total of three trials that enrolled 8728 women were analyzed. A pooled analysis was accomplished and event-based risk ratios (RR) with 95% confidence intervals (95%CI) were derived. The significant differences in disease-free survival (DFS) and overall survival (OS) were explored. A heterogeneity test was applied as well.

Results: Among three eligible trials, significant differences in favor of sequential regimen were seen in DFS (RR: 0.90; 95%CI: 0.84 to 0.98; P=0.01) and in OS (RR: 0.88; 95%CI: 0.79 to 0.98; P=0.02).

Conclusion: Considering all the available Phase III trials, sequential adjuvant chemotherapy for early breast cancer seems to add a significant benefit in both DFS and OS over concurrent regimens.

Publication types

  • Clinical Trial, Phase III
  • Meta-Analysis
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Anthracyclines / adverse effects
  • Anthracyclines / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / pathology
  • Chemotherapy, Adjuvant / statistics & numerical data
  • Disease-Free Survival
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Staging
  • Secondary Prevention / methods*
  • Taxoids / adverse effects
  • Taxoids / therapeutic use*
  • Young Adult

Substances

  • Anthracyclines
  • Taxoids