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.
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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).