Shorter time to initiation of adjuvant chemotherapy after definitive surgery may reduce risk of relapse and improve clinical outcomes in patients with highly-proliferating early breast cancer, according to a study published in the European Journal of Cancer.
In a phase 3 trial, Italian researchers led by Alberto Farolfi, MD, randomly assigned 921 patients with early breast cancer who had rapidly-proliferating tumors to receive chemotherapy with or without anthracyclines. They wanted to evaluate the optimal time interval to commence chemotherapy after surgery in these patients.
With a median follow-up of 105 months, they used the Kaplan-Meier method to determine disease-free survival, overall survival, and 95 percent confidence intervals.
The researchers found that prolonged time to initiation resulted in significant increase in risk of relapse. Upon time-dependent receiver-operating characteristic (ROC) curve analysis, they found that the best cut-off threshold for time to initiation of adjuvant chemotherapy and longer overall survival was 7 weeks, with 8-year overall survival found in 88% of patients with a time to initiation of less than 7 weeks and 78% in other patients.
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In addition, they found that time to initiation, tumor size and nodal involvement remained significantly associated with disease-free survival using a backward elimination procedure.
“Our results confirm that a shorter time to initiation of adjuvant chemotherapy may reduce relapses and possibly also improve clinical outcomes in patients with highly proliferating early breast cancer,” the authors concluded.
- Farolfi A, Scarpi E, Rocca A, et al. Time to initiation of adjuvant chemotherapy in patients with rapidly proliferating early breast cancer. European Journal of Cancer. doi: http://dx.doi.org/10.1016/j.ejca.2015.07.003. July 20, 2015.