Early-stage, operable breast cancer is widely treated with cytotoxic chemotherapy to reduce the risk of recurrence and death, and this illness is a primary global health concern. Women with early-stage, operable breast cancer who are at high risk and healthy enough to benefit from chemotherapy have typically been treated with anthracycline- and taxane-based chemotherapy regimens.
According to a study published in The Lancet, women with high-risk early-stage breast cancer who are otherwise healthy should get anthracycline and taxane treatment. However, due to concerns regarding anthracyclines’ short- and long-term toxicity, non-anthracycline chemotherapy has lately been employed. A meta-analysis of patient-level data from clinical studies comparing the two found that anthracycline-based chemotherapy was more effective in decreasing recurrence rates than taxane-based chemotherapy.
A meta-analysis of data from many trials found that anthracycline-based chemotherapy reduced recurrence rates by 14% compared to non-anthracycline-based chemotherapy. Recurrence rates fell in the first four years. They continued to diminish in years five through nine, resulting in a 2.6% absolute reduction in 10-year recurrence risk and a 1.6% absolute reduction in 10-year breast cancer mortality. Adding doxorubicin to each cycle of docetaxel plus cyclophosphamide resulted in the best 10-year absolute risk of recurrence decrease (8.7% in studies where anthracycline was delivered simultaneously with docetaxel plus cyclophosphamide).
In the meta-analysis, the cumulative dosage of anthracycline and taxane was also discovered to be a substantial predictor of the effectiveness of the chemotherapy regimen. When taxane and anthracycline were provided sequentially or at higher cumulative doses of anthracycline, the benefit was smaller than when they were administered concurrently or at lower cumulative doses. Longer treatment duration and higher anthracycline dosage each cycle resulted in a more significant reduction in breast cancer mortality, demonstrating the benefit of cumulative doses.
The meta-analysis also looked at docetaxel and paclitaxel, two taxane medications; however, differences in dose, frequency of delivery, and concomitant medication usage muddled the data. On the other hand, docetaxel was associated with fewer recurrences and appeared to be more effective than paclitaxel in decreasing breast cancer recurrence rates in all direct and indirect comparisons. The findings provide insight into the optimum chemotherapy strategies for high-risk people with early-stage breast cancer who are otherwise fit for treatment.
It suggests that anthracycline-based chemotherapy is more effective than non-anthracycline chemotherapy in decreasing recurrence rates, with the highest benefit found when anthracycline and taxane are administered together. The cumulative dose of anthracycline and taxanes and the taxane agent used may affect chemotherapy effectiveness.
These findings might help women with early-stage breast cancer by informing clinical practice and directing treatment decisions. However, while determining the appropriate chemotherapy regimen for each patient, it is critical to consider their specific characteristics and preferences. More research and clinical trials will be needed to validate these findings and optimize treatment regimens for people with early-stage breast cancer.
