Study Comparing CA to Docetaxol and Adri
This is a report of a recent study from the UK comparing CA (cytoxan and adriamycin) to DA (docetaxel and adriamycin). The findings were a very small advantage, less than the study was designed to interpret, in the DA group. The reminders are the usual: this is a single study with a small group of women with early breast cancer. Progress is made study by study, block by block, and no conclusions can ever be reached quickly. If you are in the very earliest period of breast cancer, still talking with your doctors about adjuvant or neoadjuvant (before surgery) chemotherapy, it is worth asking about this data.
Here is a summary and then a link to read more:
Five-year outcome for women randomised in a phase III trial comparing doxorubicin and cyclophosphamide with doxorubicin and docetaxel as primary medical therapy in early breast cancer: an Anglo-Celtic Cooperative Oncology Group Study
style="margin: 0.0px 0.0px 0.0px 0.0px; font: 9.0px Verdana;">
To compare the long-term outcome of women with primary or locally
advanced breast cancer randomised to receive either doxorubicin and cyclophosphamide (AC) or doxorubicin and docetaxel (AD) as primary chemotherapy. Eligible patients with histologic-proven breast cancer with primary tumours ≥3 cm, inflammatory or locally advanced disease, and no evidence of distant metastases, were randomised to receive a maximum of 6 cycles of either doxorubicin (60 mg/m2) plus cyclophosphamide (600 mg/m2) i/v or doxorubicin (50 mg/m2) plus docetaxel (75 mg/m2) i/v every 3 weeks, followed by surgery on completion of chemotherapy. Clinical and pathologic responses have previously been reported. Time to relapse, site of relapse, and all-cause mortality were recorded. This updated analysis compares long-term disease-free (DFS) and overall survival (OS) using stratified log rank methods. A total of 363 patients were randomised to AC (n = 181) or AD (n = 182). A complete pathologic response was observed in 16% for AC and 12% for AD (P = 0.43).
The number of patients with positive axillary nodes at surgery with
AC was 61% and AD 66% (P = 0.36). At a median follow-up of
99 months there is no significant difference between the two groups
for DFS (P = 0.20) and OS (P = 0.24). Deaths were due to
metastatic breast cancer in 96% of patients. Our data do not support
a clinical benefit for simultaneous administration of AD compared
with AC. However, the data do not exclude a smaller benefit than
the study was powered to detect and are consistent with an increase
in both disease-free and overall survival of about 5% for AD
compared with AC. Outcome is consistent with the pathologic
complete response following surgery.