Adjuvant dose-dense doxorubicin-cyclophosphamide versus docetaxel-doxorubicin-cyclophosphamide for high-risk breast cancer: First results of the randomised MATADOR trial (BOOG 2004-04)
A.G.J. van Rossum, M. Kok, E. van Werkhoven, M. Opdam, I.A.M. Mandjes, A.E. van Leeuwen – Stok, H. van Tinteren, A.L.T. Imholz, J.E.A. Portielje, M.M.E.M. Bos, A. van Bochove, J. Wesseling
(+3 others)
2018
European Journal of Cancer
Dose-dense administration of chemotherapy and the addition of taxanes to anthracycline-based adjuvant chemotherapy have improved breast cancer survival substantially. However, clinical trials directly comparing the additive value of taxanes with dosedense anthracycline-based chemotherapy are lacking. Patients and methods: In the multicentre, randomised, biomarker discovery Microarray Analysis in breast cancer to Tailor Adjuvant Drugs Or Regimens (MATADOR) trial, patients with pT1-3, pN0-3
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... cancer were randomised (1:1) between six adjuvant cycles of doxorubicin 60 mg/m 2 and cyclophosphamide 600 mg/m 2 every 2 weeks (ddAC) and six cycles of docetaxel 75 mg/m 2 , doxorubicin 50 mg/m 2 and cyclophosphamide 500 mg/m 2 every 3 weeks (TAC). The primary objective was to discover a predictive gene expression profile for ddAC and TAC benefit. Here we report the preplanned secondary end-point recurrence-free survival (RFS) and overall survival (OS). Results : Between 2004 and 2012, 664 patients were randomised. At 5 years, RFS was 87% (95% confidence interval [CI] 83%e91%) in the ddAC-treated patients and 88% (84e92%) in the TAC-treated subgroup (hazard ratio [HR] 0.89, 95% CI 0.62e1.28, P Z 0.53). OS at 5 years was 93% (90%e96%) in the ddAC-treated and 94% (91%e97%) in the TAC-treated patients (HR 0.89, 95% CI 0.57e1.39, P Z 0.61). Anaemia was more frequent in ddACtreated patients (62/327 patients [18.9%] versus 15/319 patients [4.7%], P < 0.001) and diarrhoea (21 [6.4%] versus 53 [16.6%], P<0.001) and peripheral neuropathy (15 [4.6%] versus 46 [14.4%], P < 0.001) were observed more often in TAC-treated patients. Conclusions: With a median follow-up of 7 years, no significant differences in RFS and OS were observed between six adjuvant cycles of ddAC and TAC in high-risk breast cancer patients. Trial registration numbers: ISRCTN61893718 and BOOG 2004-04.
doi:10.1016/j.ejca.2018.07.013
pmid:30125761
fatcat:f7juczxhu5cjzissxvg424ucr4
