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Home > Understanding Breast Cancer > Breast Cancer Research > Table 40: Different adjuvant chemotherapy combinations and overall survival in early breast cancer

  


Table 40: Different adjuvant chemotherapy combinations and overall survival in early breast cancer

  

This summary table contains detailed information about research studies. Summary tables offer an informative look at the science behind many breast cancer guidelines and recommendations. However, they should be viewed with some caution. In order to read and interpret research tables successfully, it is important to understand some key concepts. Learn how to read a research table.

Introduction: Many chemotherapy drug combinations can be used to treat early breast cancer. More and more, treatment is tailored to benefit each person's breast cancer. There is ongoing research to learn which chemotherapy combinations are the most effective for specific types of tumors.

Chemotherapy containing an anthracycline

Cyclophosphamide, methotrexate and fluoruoracil (CMF) is a well-studied chemotherapy drug combination. The Early Breast Cancer Trialists’ Collaborative Group combined the results of 17 randomized clinical trials that compared CMF to combinations that included an anthracycline drug. They found drug combinations containing an anthracycline improved overall survival (about three percent at five years and four percent at 10 years) [1].

Common chemotherapy combinations that include an anthracycline have one or more of the following drugs:

  • Cyclophosphamide (Cytoxan)
  • Docetaxel (Taxotere)
  • Doxorubicin (Adriamycin)
  • Epirubicin (Pharmorubicin)
  • Fluorouracil (5-FU)
  • Methotrexate (Trexall)
  • Paclitaxel (Taxol)

Chemotherapy containing an anthracycline plus a taxane

Two meta-analyses have combined the results of randomized clinical trials comparing chemotherapy containing an anthracycline plus a taxane (such as paclitaxel or docectaxel) to chemotherapy that did not include a taxane [2-3]. Both meta-analyses found an increase in five-year overall survival when chemotherapy included a taxane. The Cochrane Collaboration combined the results of 11 studies (that together included 18,304 women) and found a 20 percent decrease in the risk of dying within five years when chemotherapy included a taxane [3].

Learn more about chemotherapy drugs.

For information on treatment of HER2/neu-positive early breast cancers, see Table 42.

Learn about the strengths and weaknesses of different types of studies.

Study selection criteria: Early Breast Cancer Trialists' Collaborative Group pooled analysis and other pooled and meta-analyses

Chemotherapy with an Anthracycline 

 

10-Year Overall Survival 

Study 

Study Population 

Percent Surviving—
Chemotherapy with an
Anthracycline
 

Percent Surviving—
CMF Chemotherapy (No Anthracycline)
 

Absolute Improvement in Survival with Chemotherapy Containing Anthracycline Compared to Chemotherapy Not Containing an Anthracycline 

Pooled analyses 

 

Early Breast Cancer Trialists’ Collaborative Group [1]*

Overall

77%

73%

4%

 

Women younger than 45 years

 74%

 71%

 3%

 

Women 45-54

78%

77%

1%

 

Women 55-69 years

81%

79%

2%

 

Women 70 years or older

83%

78%

5%

Chemotherapy with an Anthracycline Plus a Taxane 


 

5-Year Overall Survival 

Study 

Percent Surviving—
Chemotherapy with an
Anthracycline Plus a Taxane
 

Percent Surviving—
Chemotherapy with an
Anthracycline (No Taxane)
 

Absolute Improvement in Survival with Chemotherapy Containing a Taxane Compared to Chemotherapy Not Containing a Taxane 

Pooled and meta-analyses 

Early Breast Cancer Trialists’ Collaborative Group [1]†

84%

82%

2%‡

De Laurentiis et al. [2]§

77%

74%

3%

* Combined individual data from 18,000 women in 20 randomized clinical trials

† Combined individual data from 44,000 women in 33 randomized clinical trials

‡ Absolute improvement in survival after eight years was three percent

§ Combined results from 13 randomized clinical trials that together included 22,903 women 
 

References  

1. Peto R, Davies C, Godwin J, et al. for the Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials. Lancet. 379(9814):432-44, 2012.

2. De Laurentiis M, Cancello G, D'Agostino D, et al. Taxane-based combinations as adjuvant chemotherapy of early breast cancer: a meta-analysis of randomized trials. J Clin Oncol. 26(1):44-53, 2008.

3. Ferguson T, Wilcken N, Vagg R, Ghersi D, Nowak AK. Taxanes for adjuvant treatment of early breast cancer. Cochrane Database Syst Rev. (4):CD004421, 2007.

Updated 01/13/14