Abstract | BACKGROUND:
Chemotherapy regimens that combine anthracyclines and taxanes result in improved disease-free and overall survival among women with operable lymph-node-positive breast cancer. The effectiveness of concurrent versus sequential regimens is not known. METHODS: RESULTS: At a median follow-up of 73 months, overall survival was improved in the sequential-ACT group (8-year overall survival, 83%) as compared with the doxorubicin- docetaxel group (overall survival, 79%; hazard ratio for death, 0.83; P=0.03) and the concurrent-ACT group (overall survival, 79%; hazard ratio, 0.86; P=0.09). Disease-free survival was improved in the sequential-ACT group (8-year disease-free survival, 74%) as compared with the doxorubicin- docetaxel group (disease-free survival, 69%; hazard ratio for recurrence, a second malignant condition, or death, 0.80; P=0.001) and the concurrent-ACT group (disease-free survival, 69%; hazard ratio, 0.83; P=0.01). The doxorubicin- docetaxel regimen showed noninferiority to the concurrent- ACT regimen for overall survival (hazard ratio, 0.96; 95% confidence interval, 0.82 to 1.14). Overall survival was improved in patients with amenorrhea for 6 months or more across all treatment groups, independently of estrogen-receptor status. CONCLUSIONS:
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Authors | Sandra M Swain, Jong-Hyeon Jeong, Charles E Geyer Jr, Joseph P Costantino, Eduardo R Pajon, Louis Fehrenbacher, James N Atkins, Jonathan Polikoff, Victor G Vogel, John K Erban, Priya Rastogi, Robert B Livingston, Edith A Perez, Eleftherios P Mamounas, Stephanie R Land, Patricia A Ganz, Norman Wolmark |
Journal | The New England journal of medicine
(N Engl J Med)
Vol. 362
Issue 22
Pg. 2053-65
(Jun 03 2010)
ISSN: 1533-4406 [Electronic] United States |
PMID | 20519679
(Publication Type: Clinical Trial, Phase III, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | 2010 Massachusetts Medical Society |
Chemical References |
- Taxoids
- Docetaxel
- Doxorubicin
- Cyclophosphamide
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Topics |
- Adenocarcinoma
(drug therapy, mortality, surgery)
- Amenorrhea
(chemically induced)
- Antineoplastic Combined Chemotherapy Protocols
(adverse effects, therapeutic use)
- Breast Neoplasms
(drug therapy, mortality, surgery)
- Chemotherapy, Adjuvant
- Cyclophosphamide
(administration & dosage)
- Docetaxel
- Doxorubicin
(administration & dosage)
- Drug Administration Schedule
- Female
- Follow-Up Studies
- Humans
- Middle Aged
- Multivariate Analysis
- Neoplasm Staging
- Premenopause
- Survival Analysis
- Taxoids
(administration & dosage)
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