Sequential Adjuvant Epirubicin-Based and Docetaxel Chemotherapy for Node-Positive Breast Cancer Patients: The FNCLCC PACS 01 Trial

Abstract

Sequential adjuvant chemotherapy with FEC followed by docetaxel significantly improves disease-free and overall survival in node-positive breast cancer patients and has a favorable safety profile.

FEC versus sequential docetaxel followed by epirubicin/cyclophosphamide as adjuvant chemotherapy in women with axillary node-positive early breast cancer: a randomized study of the Hellenic Oncology Research Group (HORG)

“…Several randomized trials have recently reported that adjuvant treatment with docetaxel or paclitaxel improves DFS in women with lymph-nodepositive breast cancer [3][4][5][6][7][8].…”

“…In the event of febrile neutropenia or grade 3 or 4 neutropenia, G-CSF [Filgrastim (Granocyte, Sanofi-Aventis) 5 lg Kg -1 day -1 on days [4][5][6][7][8][9][10][11] was administered in all subsequent chemotherapy cycles. If a second episode of grade 3 or 4 neutropenia or febrile neutropenia occurred despite the administration of G-CSF or in case of grade 3 or 4 thrombocytopenia, the doses of all drugs were reduced by 20% in subsequent cycles.…”

“…Based on their significant activity in the metastatic setting [2], the taxanes have also been extensively tested in the adjuvant setting in many randomized trials [3][4][5][6][7][8]; significant improvement in efficacy outcomes in terms of disease-free survival (DFS) [4,5] and overall survival (OS) [3,6,7] has been reported. Moreover, recently, a meta-analysis of 13 randomized studies including 22,903 patients demonstrated that the addition of a taxane to an anthracycline-based regimen improves DFS and OS of high-risk early breast cancer patients [9].…”

Triple Negative Breast Cancer - Our Experience and Review

“…Apart from invasive ductal carcinoma, medullary, metaplastic, secretory, pleomorphic lobular carcinomas, adenoid cystic carcinomas etc., also belong to triple negative tumours. The main characteristics of triple negative breast cancers are they are frequent in younger women (<50 years), more frequent in AfricanAmerican women, present as interval cancers, highly chemosensitive [12,13], weak association between tumour size and lymph node metastases, more aggressive, higher chance of brain metastases, high chance of recurrence during 1 st and 3 rd year and shorter survival following first metastatic event when compared to other subtypes.…”

Genomic predictors of response to doxorubicin versus docetaxel in primary breast cancer

“…Later, anthracycline combinations were found to be slightly but significantly more effective than the CMF regimen [2]. More recently, several adjuvant phase III trials have shown that taxane regimens further reduce the likelihood of recurrence and death, compared to anthracycline-containing combinations [3][4][5][6][7][8][9][10], but the absolute benefit was again small, and some trials were unable to show any advantage for the taxane arm [11,12]. Taxanes and anthracyclines can induce some acute and chronic toxicities of considerable clinical concern.…”