Paclitaxel and epirubicin versus paclitaxel and carboplatin as first-line chemotherapy in patients with advanced breast cancer: a phase III study conducted by the Hellenic Cooperative Oncology Group

Fountzilas, George; Kalofonos, Haralabos P.; Dafni, Urania; Papadimitriou, C.; Bafaloukos, Dimitrios; Papakostas, Pavlos; Kalogera‐Fountzila, Anna; Gogas, Helen; Aravantinos, G.; Moulopoulos, Lia A.; Economopoulos, Theofanis; Pectasides, Dimitrios; Maniadakis, N; Siafaka, Vassiliki; Briasoulis, Evangelos; Christodoulou, C.; Tsavdaridis, D.; Makrantonakis, P.; Razis, Evangelia; Kosmidis, P.; Skarlos, Dimosthenis; Dimopoulos, Meletios Α.

doi:10.1093/annonc/mdh395

Cited by 65 publications

(33 citation statements)

References 22 publications

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“…The latter however, needs to be viewed with caution, since subgroup analyses are usually underpowered and exploratory and are mainly hypothesis generating. Survival rates at two-years ranged from 56% for GDoc, 61% for PCb to 67% for Pw, higher than the observed survival rates in the previous randomized study by our group [10], in which the corresponding 2-year survival rates were 45% and 53% for the paclitaxel/epirubicin and PCb groups, respectively. This improvement in all treatment arms could probably be attributed to the wider use of trastuzumab and the availability of additional effective chemotherapy agents in subsequent lines of treatment such as capecitabine for patients in the current study.…”

Section: Discussioncontrasting

confidence: 75%

“…Three of them, paclitaxel and carboplatin [3,4], docetaxel and gemcitabine [5,6] and weekly paclitaxel [7][8][9] have demonstrated significant activity and manageable toxicity. Furthermore, the first of these combinations was found to be effective in a phase III trial [10], when compared to the combination of paclitaxel and epirubicin, in terms of overall response rate (ORR), survival and quality of life (QoL).…”

Section: Introductionmentioning

confidence: 99%

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A randomized phase III study comparing three anthracycline-free taxane-based regimens, as first line chemotherapy, in metastatic breast cancer

Fountzilas

Dafni

Dimopoulos

et al. 2008

Breast Cancer Res Treat

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Section: Discussioncontrasting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

A randomized phase III study comparing three anthracycline-free taxane-based regimens, as first line chemotherapy, in metastatic breast cancer

Fountzilas

Dafni

Dimopoulos

et al. 2008

Breast Cancer Res Treat

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“…These patients participated in ten trials designed and run consecutively by HeCOG, exploring different first-line treatment options for patients with MBC [8][9][10][11][12][13][14][15][16][17]. Information was collected prospectively according to the corresponding trial protocol and deposited in the central HeCOG office database.…”

Section: Methodsmentioning

confidence: 99%

Fifteen-year trends in metastatic breast cancer survival in Greece

Dafni

Grimani

Xyrafas

et al. 2009

Breast Cancer Res Treat

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In the metastatic setting, a detected time trend to improved prognosis could be attributed to the corresponding recent advances in the therapeutic approaches. The aim of the current study was to first assess, in a large cohort of well over a thousand patients, the time trends in survival in MBC for the last 15 years and second to explore its association to prognostic factors affecting outcome including therapeutic regimen. This meta-analysis uses individual patient data collected from all the trials on MBC (6 nonrandomized, 4 randomized) conducted by HeCOG from 1991 through 2006. Four 4-year time periods (1991-1994, 1995-1998, 1999-2002, and 2003-2006) were constructed for exploration of time trends in survival according to the patient's date of metastatic diagnosis. Different first line regimens in the 10 trials include anthracycline monotherapy (epirubicin, in the early 1990s) and taxanecontaining regimens either as monotherapy or in different combinations with anthracyclines or other drugs. In two phase II studies and in the last randomized study, trastuzumab was administered in all the patients with HER2 overexpressing tumors. In this study, information is based on a total of 1361 patients with a median follow up of 3.7 years and median survival of 1.9 years (median survival 1.28, 1.68, 2.20, and 2.57 years for 1991-1994, 1995-1998, 1999-2002, and 2003-2006, respectively). Survival improved significantly across diagnosis time periods, by 25, 44, and 51%, respectively, in each time period (1995)(1996)(1997)(1998) (1991)(1992)(1993)(1994). The effect of metastatic diagnosis time period remains almost unchanged in the presence of the following significant prognostic factors: performance status, hormonal receptor status, previous adjuvant chemotherapy, previous adjuvant hormonal treatment, visceral metastasis at entry, and number of metastatic sites. When exploring the effect of new systemic treatment introduction, taking into account the same significant prognostic factors, the effect of diagnosis time period disappears, and the survival improvement is explained directly by the introduction of new agents (hormonal treatment for metastatic disease: yes vs. no: HR = 0.72, P \ 0.001; taxanes at first line: yes vs. no: HR = 0.69, P = 0.002; trastuzumab at first line: yes vs. no: HR = 0.63, P \ 0.001). The results of this study provide significant evidence of improvement in prognosis of MBC patients within the last 15 years, taking into account all the important significant prognostic factors, and this improvement can be attributed to the use of new systemic treatment agents in the management of the disease.

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“…In a phase III study, the combination of paclitaxel and carboplatin showed no significant difference in survival as compared with paclitaxel and epirubicin; however, only 25% of patients in that study had received adjuvant anthracyclines [42]. Thus, the level of recommendation of such a combination for this subgroup of patients remains low (level of evidence IbB).…”

Section: Taxanes Combined With Other Cytotoxic Drugsmentioning

confidence: 97%

First-Line Chemotherapy for HER-2–Negative Metastatic Breast Cancer Patients Who Received Anthracyclines as Adjuvant Treatment

Morabito¹,

Piccirillo²,

Monaco³

et al. 2007

The Oncologist

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After completing this course, the reader will be able to:1. Discuss the value of retreatment with anthracyclines for HER-2-negative metastatic breast cancer patients who received anthracyclines as adjuvant treatment.2. Discuss the role of liposomal anthracyclines, taxanes, and combinations without anthracyclines and taxanes, or innovative treatments, including target-based agents.3. Comment on the weakness and quality of available evidence.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACT

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Paclitaxel and epirubicin versus paclitaxel and carboplatin as first-line chemotherapy in patients with advanced breast cancer: a phase III study conducted by the Hellenic Cooperative Oncology Group

Abstract: Our study suggests that the paclitaxel/Cp combination is an effective therapeutic alternative for patients with ABC in which anthracycline administration has the potential of being harmful.

Cited by 65 publications

References 22 publications

A randomized phase III study comparing three anthracycline-free taxane-based regimens, as first line chemotherapy, in metastatic breast cancer

A randomized phase III study comparing three anthracycline-free taxane-based regimens, as first line chemotherapy, in metastatic breast cancer

Fifteen-year trends in metastatic breast cancer survival in Greece

First-Line Chemotherapy for HER-2–Negative Metastatic Breast Cancer Patients Who Received Anthracyclines as Adjuvant Treatment

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