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The impact of anthracyclines in intermediate and high-risk HER2-negative early breast cancer—a pooled analysis of the randomised clinical trials PlanB and SUCCESS C
BACKGROUND: Anthracycline/cyclophosphamide-taxane-containing chemotherapy (AC-T) is the standard of care in the adjuvant treatment of HER2-negative early breast cancer (EBC), but recent studies suggest omission of anthracyclines for reduced toxicity without compromising efficacy. METHODS: Based on i...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9174181/ https://www.ncbi.nlm.nih.gov/pubmed/35194193 http://dx.doi.org/10.1038/s41416-021-01690-6 |
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author | de Gregorio, Amelie Janni, Wolfgang Friedl, Thomas W. P. Nitz, Ulrike Rack, Brigitte Schneeweiss, Andreas Kates, Ronald Fehm, Tanja Kreipe, Hans Christgen, Matthias Kümmel, Sherko Trapp, Elisabeth Wuerstlein, Rachel Hartkopf, Andreas Clemens, Michael Reimer, Toralf Häberle, Lothar Fasching, Peter A. Gluz, Oleg Harbeck, Nadia |
author_facet | de Gregorio, Amelie Janni, Wolfgang Friedl, Thomas W. P. Nitz, Ulrike Rack, Brigitte Schneeweiss, Andreas Kates, Ronald Fehm, Tanja Kreipe, Hans Christgen, Matthias Kümmel, Sherko Trapp, Elisabeth Wuerstlein, Rachel Hartkopf, Andreas Clemens, Michael Reimer, Toralf Häberle, Lothar Fasching, Peter A. Gluz, Oleg Harbeck, Nadia |
author_sort | de Gregorio, Amelie |
collection | PubMed |
description | BACKGROUND: Anthracycline/cyclophosphamide-taxane-containing chemotherapy (AC-T) is the standard of care in the adjuvant treatment of HER2-negative early breast cancer (EBC), but recent studies suggest omission of anthracyclines for reduced toxicity without compromising efficacy. METHODS: Based on individual patient data (n = 5924) pooled from the randomised Phase III trials PlanB and SUCCESS C, we compared disease-free survival (DFS) and overall survival (OS) between intermediate to high-risk HER2-negative EBC-patients treated with either six cycles of docetaxel/cyclophosphamide (TC6) or an AC-T regime using univariable and adjusted multivariable Cox regression models. RESULTS: AC-T conferred no significant DFS or OS advantage in univariable (DFS: hazard ratio (HR) for TC vs. AT 1.05, 95% confidence interval (CI): 0.89–1.24, P = 0.57; OS: HR 1.00, 95% CI: 0.80–1.26, P = 1.00) and adjusted multivariable analysis (DFS: HR 1.01, 95% CI: 0.86–1.19, P = 0.91; OS: HR 0.97, 95% CI: 0.77–1.22, P = 0.79). Patients receiving TC6 had significantly fewer grade 3–4 adverse events. Exploratory subgroup analysis showed that AC-T was associated with significantly better DFS and OS in pN2/3 patients, specifically in those with lobular histology. CONCLUSION: For most patients with HER2-negative EBC, AC-T is not associated with a survival benefit compared to TC6. However, patients with lobular pN2/pN3 tumours seem to benefit from anthracycline-containing chemotherapy. |
format | Online Article Text |
id | pubmed-9174181 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-91741812022-06-09 The impact of anthracyclines in intermediate and high-risk HER2-negative early breast cancer—a pooled analysis of the randomised clinical trials PlanB and SUCCESS C de Gregorio, Amelie Janni, Wolfgang Friedl, Thomas W. P. Nitz, Ulrike Rack, Brigitte Schneeweiss, Andreas Kates, Ronald Fehm, Tanja Kreipe, Hans Christgen, Matthias Kümmel, Sherko Trapp, Elisabeth Wuerstlein, Rachel Hartkopf, Andreas Clemens, Michael Reimer, Toralf Häberle, Lothar Fasching, Peter A. Gluz, Oleg Harbeck, Nadia Br J Cancer Article BACKGROUND: Anthracycline/cyclophosphamide-taxane-containing chemotherapy (AC-T) is the standard of care in the adjuvant treatment of HER2-negative early breast cancer (EBC), but recent studies suggest omission of anthracyclines for reduced toxicity without compromising efficacy. METHODS: Based on individual patient data (n = 5924) pooled from the randomised Phase III trials PlanB and SUCCESS C, we compared disease-free survival (DFS) and overall survival (OS) between intermediate to high-risk HER2-negative EBC-patients treated with either six cycles of docetaxel/cyclophosphamide (TC6) or an AC-T regime using univariable and adjusted multivariable Cox regression models. RESULTS: AC-T conferred no significant DFS or OS advantage in univariable (DFS: hazard ratio (HR) for TC vs. AT 1.05, 95% confidence interval (CI): 0.89–1.24, P = 0.57; OS: HR 1.00, 95% CI: 0.80–1.26, P = 1.00) and adjusted multivariable analysis (DFS: HR 1.01, 95% CI: 0.86–1.19, P = 0.91; OS: HR 0.97, 95% CI: 0.77–1.22, P = 0.79). Patients receiving TC6 had significantly fewer grade 3–4 adverse events. Exploratory subgroup analysis showed that AC-T was associated with significantly better DFS and OS in pN2/3 patients, specifically in those with lobular histology. CONCLUSION: For most patients with HER2-negative EBC, AC-T is not associated with a survival benefit compared to TC6. However, patients with lobular pN2/pN3 tumours seem to benefit from anthracycline-containing chemotherapy. Nature Publishing Group UK 2022-02-22 2022-06-01 /pmc/articles/PMC9174181/ /pubmed/35194193 http://dx.doi.org/10.1038/s41416-021-01690-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article de Gregorio, Amelie Janni, Wolfgang Friedl, Thomas W. P. Nitz, Ulrike Rack, Brigitte Schneeweiss, Andreas Kates, Ronald Fehm, Tanja Kreipe, Hans Christgen, Matthias Kümmel, Sherko Trapp, Elisabeth Wuerstlein, Rachel Hartkopf, Andreas Clemens, Michael Reimer, Toralf Häberle, Lothar Fasching, Peter A. Gluz, Oleg Harbeck, Nadia The impact of anthracyclines in intermediate and high-risk HER2-negative early breast cancer—a pooled analysis of the randomised clinical trials PlanB and SUCCESS C |
title | The impact of anthracyclines in intermediate and high-risk HER2-negative early breast cancer—a pooled analysis of the randomised clinical trials PlanB and SUCCESS C |
title_full | The impact of anthracyclines in intermediate and high-risk HER2-negative early breast cancer—a pooled analysis of the randomised clinical trials PlanB and SUCCESS C |
title_fullStr | The impact of anthracyclines in intermediate and high-risk HER2-negative early breast cancer—a pooled analysis of the randomised clinical trials PlanB and SUCCESS C |
title_full_unstemmed | The impact of anthracyclines in intermediate and high-risk HER2-negative early breast cancer—a pooled analysis of the randomised clinical trials PlanB and SUCCESS C |
title_short | The impact of anthracyclines in intermediate and high-risk HER2-negative early breast cancer—a pooled analysis of the randomised clinical trials PlanB and SUCCESS C |
title_sort | impact of anthracyclines in intermediate and high-risk her2-negative early breast cancer—a pooled analysis of the randomised clinical trials planb and success c |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9174181/ https://www.ncbi.nlm.nih.gov/pubmed/35194193 http://dx.doi.org/10.1038/s41416-021-01690-6 |
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