Dose-Dense Adjuvant Chemo Associated with Improved Survival in Node-Positive Breast Cancer

According to a recent study published online in the journal The Lancet, researchers have found that dose-dense adjuvant chemotherapy improved disease-free survival compared with standard interval chemotherapy in patients with node-positive early breast cancer, but the addition of fluorouracil to sequential EC-P (epirubicin, cyclophosphamide, paclitaxel) did not improve disease-free survival outcomes.

For the 2×2 factorial, open-label, phase 3 trial, researchers sought to evaluate whether the addition of fluorouracil to EC-P or increasing the density of dosing is beneficial in patients with node-positive early breast cancer. 

Researchers enrolled 2,091 patients and randomly assigned them to receive either dose-dense chemotherapy every 2 weeks with fluorouracil plus EC-P (FEC-P) or EC-P or to receive standard-interval chemotherapy every 3 weeks with FEC-P or EC-P.

Results showed that after a median follow-up of 7.0 years, 26% of patients given EC-P every 3 weeks, 29% of those given FEC-P every 3 weeks, 22% of those given EC-P every 2 weeks, and 23% of those given FEC-P every 2 weeks experienced a disease-free survival event.

The 5-year disease-free survival was 81% in those treated every 2 weeks and 76% in those treated every 3 weeks (HR = 0.65; 95% CI: 0.65 – 0.92; P = 0.004).

The 5-year disease-free survival was 78% in the FEC-P groups and 79% in the EC-P groups (HR = 1.06; 95% CI: 0.89 – 1.25; P = 0.561).

Reference

1. Del Mastro L, De Placido S, Bruzzi P, et al. Fluorouracil and dose-dense chemotherapy in adjuvant treatment of patients with early-stage breast cancer: an open-label, 2×2 factorial, randomised phase 3 trial. Lancet. 2015. [Epub ahead of print]. doi: 10.1016/S0140-6736(14)62048-1.