Weekly taxane–anthracycline combination regimen versus tri-weekly anthracycline-based regimen for the treatment of locally advanced breast cancer: a randomized controlled trial

Abstract

BackgroundExtensive studies have confirmed the efficacy of taxanes in combination with anthracycline-based chemotherapy on breast cancer. However, few studies have assessed the efficacy of weekly taxane–anthracycline regimens on locally advanced breast cancer. This study was to compare the efficacy and safety of a weekly taxane–anthracycline regimen with those of tri-weekly anthracycline-based regimen in patients with locally advanced breast cancer.MethodsPatients with locally advanced breast cancer were randomized to receive 4–6 cycles of neoadjuvant chemotherapy with tri-weekly 5-fluorouracil–epirubicin–cyclophosphamide (FEC) regimen or weekly paclitaxel–epirubicin (PE) regimen. The primary endpoint was the pathologic complete response (pCR) rate. Other endpoints included the clinical tumor response, breast-conserving surgery rate, and adverse events.ResultsBetween March 2010 and September 2013, 293 patients were randomized to the FEC (n = 151) and PE (n = 142) arms. The overall clinical response rate was significantly higher in the PE arm than in the FEC arm (76.06% vs. 59.95%, P = 0.001). Consistently, the post-chemotherapy pathologic T and N stages were significantly lower in the PE arm than in the FEC arm (P < 0.001). However, the pCR rate was similar in the two arms (10.61% vs. 12.31%, P = 0.665). Overall, 36 (27.27%) patients in the FEC arm and 6 (35.28%) in the PE arm were qualified for breast-conserving surgery. Most adverse events were comparable in both arms, with more severe neutropenia in the PE arm than in the FEC arm (11.97% vs. 5.96%, P = 0.031).ConclusionsIn patients with locally advanced breast cancer, weekly PE was not superior to FEC in terms of pCR. However, weekly PE has a higher response rate and superior down-staging effects. On this account, the PE regimen may be considered an alternative option for locally advanced breast cancer. Long-term follow-up data are needed to confirm the efficacy of this regimen on locally advanced breast cancer. Trial registration Chinese clinical trial registry, ChiCTR-TRC-10001043, September 21, 2014

<p>Effects of Chemotherapy on Serum Lipids in Chinese Postoperative Breast Cancer Patients</p>

“…It is well known that anthracycline is the cornerstone of breast cancer chemotherapy; Meanwhile, taxane has been widely adopted in the treatment of breast cancer patients. 40 – 42 Many clinical trials had found that the taxane incorporated into anthracycline-based chemotherapy regimens could prolonge the disease-free survival and overall survival of breast cancer patients. 42 – 44 This study observed that the levels of TG, TC, LDL-C and Lpa in breast cancer patients increased significantly, while the levels of HDL-C obviously decreased after anthracycline-based chemotherapy, which was consistent with previous findings.…”

“… 40 – 42 Many clinical trials had found that the taxane incorporated into anthracycline-based chemotherapy regimens could prolonge the disease-free survival and overall survival of breast cancer patients. 42 – 44 This study observed that the levels of TG, TC, LDL-C and Lpa in breast cancer patients increased significantly, while the levels of HDL-C obviously decreased after anthracycline-based chemotherapy, which was consistent with previous findings. 45 Some studies proposed that anthracyclines affected hepatocytes metabolism of serum lipids and lipoproteins by reducing the efficiency of mitochondrial respiration and the content of cytoplasmic adenosine triphosphate.…”

Effects of chemotherapy on serum lipids in Chinese postoperative breast cancer patients

“…It is well known that anthracycline is the cornerstone of breast cancer chemotherapy; Meanwhile, taxane has been widely adopted in the treatment of breast cancer patients. [40][41][42] Many clinical trials had found that the taxane incorporated into anthracycline-based chemotherapy regimens could prolonge the disease-free survival and overall survival of breast cancer patients. [42][43][44] This study observed that the levels of TG, TC, LDL-C and Lpa in breast cancer patients increased significantly, while the levels of HDL-C obviously decreased after anthracycline-based chemotherapy, which was consistent with previous findings.…”

“…[40][41][42] Many clinical trials had found that the taxane incorporated into anthracycline-based chemotherapy regimens could prolonge the disease-free survival and overall survival of breast cancer patients. [42][43][44] This study observed that the levels of TG, TC, LDL-C and Lpa in breast cancer patients increased significantly, while the levels of HDL-C obviously decreased after anthracycline-based chemotherapy, which was consistent with previous findings. 45 Some studies proposed that anthracyclines affected hepatocytes metabolism of serum lipids and lipoproteins by reducing the efficiency of mitochondrial respiration and the content of cytoplasmic adenosine triphosphate.…”

Oncological outcome of complete response after neoadjuvant chemotherapy for breast conserving surgery: a systematic review and meta-analysis

“…NAC regimens in our study were classified as paclitaxel-epirubicin-based regimen and epirubicin without paclitaxel-based regimen. Paclitaxel-epirubicin-based regimen had higher BCS rate, and this may attribute to its superior downstaging effects [ 32 ].…”