A randomised pilot Phase II study of doxorubicin and cyclophosphamide (AC) or epirubicin and cyclophosphamide (EC) given 2 weekly with pegfilgrastim (accelerated) vs 3 weekly (standard) for women with early breast cancer
2009

Accelerated Chemotherapy for Early Breast Cancer

Sample size: 126 publication Evidence: moderate

Author Information

Author(s): Jones R L, Walsh G, Ashley S, Chua S, Agarwal R, O'Brien M, Johnston S, Smith I E

Primary Institution: Royal Marsden NHS Trust

Hypothesis

Accelerated (dose-dense) chemotherapy may increase the efficacy of cancer chemotherapy without increasing toxicity.

Conclusion

Accelerated AC and EC with pegfilgrastim are safe and feasible regimens in the treatment of early breast cancer with less neutropenia than conventional 3 weekly schedules.

Supporting Evidence

  • Significantly more grade 3/4 day one neutropenia was seen with standard compared to accelerated regimens.
  • Falls in left ventricular ejection fraction were not increased with accelerated treatment.
  • Accelerated regimens were well tolerated with fewer serious adverse events.

Takeaway

This study looked at two ways to give chemotherapy to women with early breast cancer. Giving it more often helped reduce some side effects.

Methodology

Patients were randomised to one of four arms receiving either standard or accelerated chemotherapy regimens.

Limitations

The study was not powered to detect differences in efficacy.

Participant Demographics

Median age was 50 years, with a mix of premenopausal and postmenopausal women.

Statistical Information

P-Value

0.01

Statistical Significance

p=0.01

Digital Object Identifier (DOI)

10.1038/sj.bjc.6604862

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