Conventional versus reverse sequence of neoadjuvant epirubicin/cyclophosphamide and docetaxel: sequencing results from ABCSG-34
Year: 2021
Type: article
Abstract: BACKGROUND: Preoperative chemotherapy containing anthracyclines and taxanes is well established in early-stage breast cancer. Previous studies have suggested that the chemotherapy sequence may matter but definitive evidence is missing. ABCSG trial 34 evaluated the activity of the MUC1 vaccine tecemotide when added to neoadjuvant treatment; the study provided the opportunity for the second randomisation to compare two different anthracycline/taxane sequences. METHODS: HER2-negative early-stage breast cancer patients were recruited to this randomised multicentre Phase 2 study. Patients in the chemotherapy cohort (n = 311) were additionally randomised to a conventional or reversed sequence of epirubicin/cyclophosphamide and docetaxel. Residual cancer burden (RCB) with/without tecemotide was defined as primary study endpoint; RCB in the two chemotherapy groups was a key secondary endpoint. RESULTS: No significant differences in terms of RCB 0/I (40.1% vs. 37.2%; P = 0.61) or pathologic complete response (pCR) rates (24.3% vs. 25%, P = 0.89) were observed between conventional or reverse chemotherapy sequence. No new safety signals were reported, and upfront docetaxel did not result in decreased rates of treatment delay or discontinuation. CONCLUSION: Upfront docetaxel did not improve chemotherapy activity or tolerability; these results suggest that upfront neoadjuvant treatment with anthracyclines remains a valid option.
Source: British Journal of Cancer
Authors: Rupert Bartsch, Christian F. Singer, Georg Pfeiler, Michael Hubalek, Herbert Stoeger, Angelika Pichler, Edgar Petru, Vesna Bjelic-Radisic, Richard Greil, Margaretha Rudas, Tea Maria Muy-Kheng, Viktor Wette, Andreas L. Petzer, Paul Sevelda, Daniel Egle, Peter C. Dubsky, Martin Filipits, Florian Fitzal, Ruth Exner, Raimund Jakesz, Marija Balic, Christoph Tinchon, Zsuzsanna Bago-Horvath, Sophie Frantal, Michael Gnant, for the Austrian Breast and Colorectal Cancer Study Group
Institutions: Medical University of Vienna, Medical University of Graz, LKH Hochsteiermark, Witten/Herdecke University, Helios Universitätsklinikum Wuppertal, Paracelsus Medical University, Ordensklinikum Linz Barmherzige Schwestern, Krankenhaus der Elisabethinen, Innsbruck Medical University, Universität Innsbruck, Comprehensive Cancer Center Vienna, Austrian Breast & Colorectal Cancer Study Group
Language: English
Subfield: Cancer Research
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $4,480
Funder: Merck KGaA
OpenAlex ID: W3138719084