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Cyclophosphamide, epirubicin, and fluorouracil versus dose-dense epirubicin and cyclophosphamide followed by paclitaxel versus doxorubicin and cyclophosphamide followed by paclitaxel in node-positive or high-risk node-negative breast cancer
Journal of Clinical Oncology, 11/13/09

Burnell M et al. – Three-weekly AC/T is significantly inferior to CEF or EC/T in terms of RFS. It is too early to detect any difference between CEF and dose-dense EC/T.

Methods

After lumpectomy or mastectomy, women 60 years of age or younger with axillary node-positive or high-risk node-negative breast cancer randomly assigned to receive CEF, EC/T, or AC/T for 6 months
This article reports interim analysis for RFS, which was planned after 227 recurrences

Results

Total of 2,104 patients enrolled
Median follow-up is 30.4 months
Hazard ratios for recurrence are as follows: AC/T versus CEF, 1.49 (95% CI, 1.12 to 1.99), P = .005; AC/T versus EC/T, 1.68 (95% CI, 1.25 to 2.27), P = .0006; and EC/T versus CEF, 0.89 (95% CI, 0.64 to 1.22), P = .46
3y RFS rates for CEF, EC/T, and AC/T 90.1%, 89.5%, and 85.0%, respectively
More febrile neutropenia with CEF (22.3%) and EC/T (16.4%) compared with AC/T (4.8%), but more neuropathy with the last two regimens