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Open Access 01-10-2017 | Clinical trial

Improved survival for sequentially as opposed to concurrently delivered neoadjuvant chemotherapy in non-metastatic breast cancer

Authors: B. E. P. J. Vriens, I. J. H. Vriens, M. J. B. Aarts, S. M. van Gastel, F. W. P. J. van den Berkmortel, T. J. Smilde, L. J. C. van Warmerdam, D. J. van Spronsen, P. G. M. Peer, M. de Boer, V. C. G. Tjan-Heijnen, on behalf of the Breast Cancer Trialists’ Group of the Netherlands (BOOG)

Published in: Breast Cancer Research and Treatment | Issue 3/2017

Abstract

Purpose

The INTENS study was designed to determine whether delivering neoadjuvant chemotherapy at a higher dose in a shorter period of time improves outcome of breast cancer patients.

Methods

Women with newly diagnosed breast cancer were randomly assigned to neoadjuvant chemotherapy consisting of four cycles of doxorubicin and cyclophosphamide followed by four cycles of docetaxel (AC 60/600–T 100 mg/m²) or six cycles of TAC as triplet chemotherapy (75/50/500 mg/m²) every 3 weeks. The primary outcome was the pathologic complete response (pCR), with disease-free and overall survival as secondary endpoints.

Results

In total, 201 patients were included. The pCR rates were 28% for patients treated with AC-T and 19% for patients treated with TAC, with an odds ratio of 1.60 (95% CI 0.90–3.21). With a median follow-up of 6 years (range 0.04–8.41 years), the five-year disease-free survival was 81% for patients treated with sequentially AC-T and 71% for patients treated with concurrent triplet TAC chemotherapy with a stratified hazard ratio (HR) of 0.50 (95% CI 0.29–0.86). Five-year overall survival was 84% versus 76%, respectively, with a stratified HR of 0.55 (95% CI 0.29–1.03).

Conclusions

No differences were observed between the two treatment arms with respect to pCR rate, but the sequentially delivered chemotherapy outperformed the triplet combination chemotherapy in terms of survival, despite a lower cumulative dose per agent. GOV nr NCT00314977.

Available only for authorised users

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Title: Improved survival for sequentially as opposed to concurrently delivered neoadjuvant chemotherapy in non-metastatic breast cancer
Authors: B. E. P. J. Vriens
I. J. H. Vriens
M. J. B. Aarts
S. M. van Gastel
F. W. P. J. van den Berkmortel
T. J. Smilde
L. J. C. van Warmerdam
D. J. van Spronsen
P. G. M. Peer
M. de Boer
V. C. G. Tjan-Heijnen
on behalf of the Breast Cancer Trialists’ Group of the Netherlands (BOOG)
Publication date: 01-10-2017
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 3/2017
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-017-4364-8

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