Four cycles of docetaxel and cyclophosphamide as adjuvant chemotherapy in node negative breast cancer: A real-world study. (December 2020)

• Record Type: Journal Article
• Authors: Batra, Atul; Hannouf, Malek B.; Alsafar, Noura; Lupichuk, Sasha
• Is Part Of: Breast. Volume 54(2020)
• Page Start: 1
• Page End: 7
• Publication Date: 2020-12
• Subjects: Hormone receptor-positive -- Breast cancer -- Adjuvant chemotherapy -- Non-anthracycline -- Four cycles -- Docetaxel -- Cyclophosphamide; Breast -- Diseases -- Periodicals; Breast -- Tumors -- Periodicals; Breast -- Periodicals; Electronic journals; Periodicals; 616
• DOI: 10.1016/j.breast.2020.08.002
• Languages: English
• ISSNs: 0960-9776

Abstract

Abstract: Introduction: The optimal number of cycles of adjuvant docetaxel and cyclophosphamide (DC) in patients with node negative breast cancer is not known. We aimed to analyse the survival outcomes of patients with node negative and human epidermal growth factor receptor (HER2)-negative breast cancer treated with four cycles of DC. Methods: Patients with node negative and HER2-negative breast cancer treated with four cycles of DC after surgery in a large Canadian province from 2008 to 2012 were identified. We analysed the 4-year and 9-year invasive disease free survival (iDFS) and overall survival (OS). Cox regression models were constructed to examine the associations of clinical characteristics with survival outcomes. Results: A total of 657 patients were eligible for the current analysis. The median age was 53 years and 71.2% of patients had hormone receptor-positive breast cancer. Approximately three-fourths of patients had grade III tumours. At a median follow-up of nine years, the 4-year iDFS and OS were 91.0% and 95.5% and the corresponding 9-year rates were 80.5% and 88.0%, respectively. On multivariable Cox regression analysis, grade III tumour predicted worse iDFS (hazard ratio [HR], 2.15; 95% confidence interval [CI], 1.09–4.21; P = 0.026) and OS (HR, 3.15; 95% CI, 1.18–8.45; P = 0.022). Conclusions: Adjuvant chemotherapy with four cycles of DC in a select population of node negative breast cancer was associated with encouraging long-term survival. In the absence of a randomized comparison between four and six cycles of DC, this study presents real-world evidence to consider four cycles of DC as a reasonable option. Highlights: Non-anthracycline adjuvant chemotherapy administered in node negative breast cancer. Not known if four or six cycles of docetaxel and cyclophosphamide is optimal. Long-term survival rates in this real-world study using four cycles are encouraging. In absence of randomized comparison, four cycles is a reasonable option.