Feasibility of 4 Cycles of Docetaxel and Cyclophosphamide Every 14 Days as an Adjuvant Regimen for Breast Cancer: A Wisconsin Oncology Network Study

Abstract

Introduction Dose-dense therapies have had a major impact on reducing toxicity and improving outcomes in breast cancer. A combination of docetaxel plus cyclophosphamide (TC) every 3 weeks has emerged as a common chemotherapy regimen used for treatment of node-negative or lower-risk node-positive breast cancer. We tested whether it is feasible to deliver TC on a dose-dense schedule, with therapy completed within 10 weeks. Methods We enrolled women with early stage breast cancer on a single-arm phase II study of adjuvant dose-dense TC (ddTC) through a regional oncology network. All women completed primary surgery prior to accrual and subsequent therapy with TC was deemed appropriate by the treating physician. Planned treatment was docetaxel 75 mg/m2 plus cyclophosphamide 600 mg/m2 every 2 weeks for 4 cycles with subcutaneous pegfilgrastim 6 mg administered 24-48 hours after the administration of each chemotherapy cycle. Results Of 42 women enrolled, 41 were evaluable by prespecified criteria. Of these, 37 (90.2%) completed therapy within 10 weeks and 34 (83%) completed therapy at 8 weeks without dose modification. Rates of neuropathy were similar to that reported previously. The rate of neutropenic fever was low (2.5%). Rash and plantar/palmar erythrodythesia were common and reached grade 3 in four subjects (9.8%). Conclusion Dose-dense TC is feasible with tolerability profiles similar to standard TC and a low likelihood of neutropenic fever. This study supports further clinical development of this 8-week adjuvant chemotherapy regimen.

Taxanes in adjuvant breast cancer treatment

“…A small stage II study of Burkard et al, compared standard docetaxel (4xTC every three weeks) with dose dense application (4xTC every two weeks), supported by granulocyte colonies growth factors. Both regimens have shown a similar profi le of toxicity and tolerability (27). Further research results are expected.…”

Update on Adjuvant Chemotherapy for Early Breast Cancer

“…Thus, our study showed that dose-dense TC has tolerability profiles similar to standard TC, has low risk of neutropenic fever, and is expected to be equally effective to or more effective than standard TC. 41 Among the standard chemotherapy regimens, dose-dense TC is completed in 8 weeks, making it the most expeditious standard regimen available today ( Fig. 1 ).…”