Giffoni de Mello Morais Mata Danilo, Pezo Rossanna C, Chan Kelvin K W, Menjak Ines, Eisen Andrea, Trudeau Maureen
Division of Medical Oncology, Verspeeten Family Cancer Centre, London Health Sciences Centre, London, ON N6A 5W9, Canada.
Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada.
Curr Oncol. 2024 Dec 25;32(1):6. doi: 10.3390/curroncol32010006.
Anthracycline-taxane chemotherapy is the gold standard in high-risk breast cancer (BC), despite the potential risk of congestive heart failure (CHF). A suitable alternative for anthracycline-sparing chemotherapy is through the combination of docetaxel and cyclophosphamide (TC).
Through a retrospective study of stage I-III HER2-negative BC, using administrative databases, we analyzed a total of 10,634 women treated with adjuvant chemotherapy in Ontario, Canada, between 2009 and 2017. We compared TC versus standardized anthracycline-taxane chemotherapies (ACT and FEC-D). We investigated the overall survival (OS), and explored the incidence of CHF, emergency department (ED) visits and febrile neutropenia.
With a median follow-up of 5.5 years, the 5-year analysis showed an increased OS in patients treated with TC, versus those treated with ACT, HR 0.77 (0.63-0.95, = 0.015). Among ER+ BC, there was an increased OS in patients treated with ACT and FEC-D, versus those treated with TC, HR 0.70 (0.52-0.95, = 0.021) and HR 0.71 (0.56-0.91, = 0.007), respectively. There were no substantial differences in CHF, between TC and anthracycline-based treatments. Patients treated with TC and FEC-D had more ED visits, compared to those treated with ACT.
Our study shows that anthracycline-taxane regimens were the most commonly prescribed adjuvant chemotherapy options in HER2-negative BC. Women who received ACT had the lowest OS, likely due to their unfavorable pathology.
尽管存在充血性心力衰竭（CHF）的潜在风险，但蒽环类药物-紫杉烷化疗仍是高危乳腺癌（BC）的金标准。多西他赛和环磷酰胺联合使用（TC）是一种合适的蒽环类药物保留化疗替代方案。
通过对I-III期HER2阴性乳腺癌的回顾性研究，利用行政数据库，我们分析了2009年至2017年间在加拿大安大略省接受辅助化疗的10634名女性。我们比较了TC与标准化蒽环类药物-紫杉烷化疗方案（ACT和FEC-D）。我们研究了总生存期（OS），并探讨了CHF、急诊就诊和发热性中性粒细胞减少的发生率。
中位随访5.5年，5年分析显示，与接受ACT治疗的患者相比，接受TC治疗的患者OS增加，风险比（HR）为0.77（0.63-0.95，P = 0.015）。在雌激素受体阳性（ER+）乳腺癌患者中，与接受TC治疗的患者相比，接受ACT和FEC-D治疗的患者OS增加，HR分别为0.70（0.52-0.95，P = 0.021）和0.71（0.56-0.91，P = 0.007）。TC与基于蒽环类药物的治疗在CHF方面无显著差异。与接受ACT治疗的患者相比，接受TC和FEC-D治疗的患者急诊就诊次数更多。
我们的研究表明，蒽环类药物-紫杉烷方案是HER2阴性乳腺癌最常用的辅助化疗方案。接受ACT治疗的女性OS最低，可能是由于其病理情况不佳。
