Originally published as JCO Early Release 10.1200/JCO.2008.18.4028 on February 9 2009

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Jones, S. Articles by Savin, M. A. Search for Related Content PubMed PubMed Citation Articles by Jones, S. Articles by Savin, M. A. Social Bookmarking                            What's this?

Docetaxel With Cyclophosphamide Is Associated With an Overall Survival Benefit Compared With Doxorubicin and Cyclophosphamide: 7-Year Follow-Up of US Oncology Research Trial 9735

From the US Oncology Research Inc, Houston; Baylor-Sammons Cancer Center, Dallas, TX; Cooper Clinic PA, Ft Smith, AR; and the Vermont Cancer Center, Burlington, VT.

Corresponding author: Stephen Jones, MD, US Oncology Research Inc, Texas Oncology PA, 3535 Worth St, 6th floor, Dallas, TX 75246; e-mail: Steve.Jones{at}USOncology.com.

Purpose We previously reported that four cycles of docetaxel/cyclophosphamide (TC) produced superior disease-free survival (DFS) compared with four cycles of doxorubicin/cyclophosphamide (AC) in early breast cancer. Older women are under-represented in adjuvant chemotherapy trials. In our trial 16% of patients were 65 years. We now report 7-year results for DFS and overall survival (OS) as well as the impact of age, hormone receptor status, and HER2 status on outcome and toxicity.

Patients and Methods Patients were randomly assigned to receive either four cycles of standard-dose AC (60/600 mg/m²; n = 510), or TC (75/600 mg/m²; n = 506), administered by intravenous infusion every 3 weeks.

Results The median age in women younger than 65, was 50 years (range, 27 to 64) and for women 65 was 69 years (range, 65 to 77). Baseline characteristics in the two age subgroups were generally well matched, except that older women tended to have more lymph node involvement. At a median of 7 years follow-up, the difference in DFS between TC and AC was significant (81% TC v 75% AC; P = .033; hazard ratio [HR], 0.74; 95% CI 0.56 to 0.98) as was OS (87% TC v 82% AC; P = .032; HR, 0.69; 95% CI, 0.50 to 0.97). TC was superior in older patients as well as younger patients. There was no interaction of hormone-receptor status or HER-2 status and treatment. Older women experienced more febrile neutropenia with TC and more anemia with AC.

Conclusion With longer follow-up, four cycles of TC was superior to standard AC (DFS and OS) and was a tolerable regimen in both older and younger patients.

Supported by sanofi-aventis, Bridgewater, NJ.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				K. I. Pritchard Commentary: Anthracyclines in Early-Stage Breast Cancer: Is It the End of an Era? Oncologist, October 1, 2009; 14(10): 959 - 962. [Full Text] [PDF]

				D. Soong, R. Haj, M. G. Leung, R. Myers, B. Higgins, J. Myers, and S. Rajagopal High Rate of Febrile Neutropenia in Patients With Operable Breast Cancer Receiving Docetaxel and Cyclophosphamide J. Clin. Oncol., September 10, 2009; 27(26): e101 - e102. [Full Text] [PDF]

				D. Takabatake, N. Taira, F. Hara, T. Sien, S. Kiyoto, S. Takashima, K. Aogi, S. Ohsumi, H. Doihara, and S. Takashima Feasibility Study of Docetaxel with Cyclophosphamide as Adjuvant Chemotherapy for Japanese Breast Cancer Patients Jpn. J. Clin. Oncol., August 1, 2009; 39(8): 478 - 483. [Abstract] [Full Text] [PDF]

				H. B. Muss, D. A. Berry, C. T. Cirrincione, M. Theodoulou, A. M. Mauer, A. B. Kornblith, A. H. Partridge, L. G. Dressler, H. J. Cohen, H. P. Becker, et al. Adjuvant Chemotherapy in Older Women with Early-Stage Breast Cancer N. Engl. J. Med., May 14, 2009; 360(20): 2055 - 2065. [Abstract] [Full Text] [PDF]

				L. Gianni and P. Valagussa Anthracyclines and Early Breast Cancer: The End of an Era? J. Clin. Oncol., March 10, 2009; 27(8): 1155 - 1157. [Full Text] [PDF]