Details

Autor(en) / Beteiligte

• Trudeau, Maureen
• Charbonneau, Flay
• Gelmon, Karen
• Laing, Kara
• Latreille, Jean
• Mackey, John
• McLeod, Deanna
• Pritchard, Kathy
• Provencher, Louise
• Verma, Shailendra

Titel

Selection of adjuvant chemotherapy for treatment of node-positive breast cancer

Ist Teil von

• The lancet oncology, 2005-11, Vol.6 (11), p.886-898

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2005

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• Over the past two decades, several studies have suggested that regimens that contain anthracyclines are more effective than those that do not. A meta-analysis by the 2005 Early Breast Cancer Trialists' Collaborative Group confirmed that about 6 months of anthracycline-based polychemotherapy in the adjuvant setting reduced the yearly death rate from breast cancer by about 38% for women younger than 50 years and by 20% for women aged 50–69 years. Although this meta-analysis found that survival was better with regimens that contain anthracycline than with regimens based on cyclophosphamide, methotrexate, and fluorouracil, the best use of anthracycline-based regimens remains unclear. Adjuvant regimens in use can be categorised into three groups: standard-dose anthracycline; escalated-dose epirubicin; and anthracyclines and taxanes. The duration of treatment and combination of dose and drugs varies between these three categories. We reviewed the three types of regimen to establish which provide a better outcome in terms of safety, efficacy, cost, and convenience to patients. We found that both escalated-dose epirubicin and anthracycline–taxane regimens were most effective in terms of disease-free survival and overall survival. Of the specific anthracycline-based regimens, the docetaxel, doxorubicin, and cyclophosphamide regimen (TAC); the fluorouracil, 100 mg epirubicin, and cyclophosphamide regimen (FEC100); and the cyclophosphamide, epirubicin, and fluorouracil regimen (CEF) produced the greatest proportional decreases in 5-year death rate.