Breast Cancer Research and Treatment

, Volume 142, Issue 3, pp 549–558

Superior outcome after neoadjuvant chemotherapy with docetaxel, anthracycline, and cyclophosphamide versus docetaxel plus cyclophosphamide: results from the NATT trial in triple negative or HER2 positive breast cancer

  • Xiaosong Chen
  • Guolin Ye
  • Chenfang Zhang
  • Xinzheng Li
  • Yiding Chen
  • Xiaohong Xie
  • Hong Zheng
  • Yali Cao
  • Kejin Wu
  • Duo Ni
  • Jinhai Tang
  • Ziguo Wei
  • Kunwei Shen
Clinical trial

DOI: 10.1007/s10549-013-2761-1

Cite this article as:
Chen, X., Ye, G., Zhang, C. et al. Breast Cancer Res Treat (2013) 142: 549. doi:10.1007/s10549-013-2761-1

Abstract

The purpose of this study is to evaluate the efficacy and safety of docetaxel plus cyclophosphamide (TC) compared with docetaxel, anthracycline, and cyclophosphamide (TEC) in neoadjuvant treatment of triple negative or HER2 positive breast cancer. Eligible breast cancer patients were randomized to receive six cycles of TC or TEC. The primary end point was pathological complete remission (pCR). Secondary end points included safety, clinical response rate, and survival outcome. One hundred and two patients were initially randomized and 96 patients were available for efficacy analysis. 96.9 % patients were treated with epirubicin as an anthracycline agent. pCR rates were 6.8 % (3/45) and 17.6 % (9/51) in TC and TEC group, respectively, P = 0.113. After a mean follow up of 20 (3–36) months, non-anthracycline-containing TC regimen treatment resulted in a worse event-free survival (adjusted hazard ratio [HR] 2.42; 95 % CI 1.11–5.30) and disease-free survival (HR 2.85; 95 % CI 1.21–6.74) compared with TEC regimen, which was more apparent in triple negative subtype. Severe adverse event rates were similar, except that patients treated with TEC had a higher rate of neutropenia and leucopenia. TEC treatment had a superior survival outcome and trend of higher pCR rate compared with TC in this trial setting, especially in triple negative subtype, which deserves further validation.

Keywords

Triple negative breast cancerNeoadjuvant chemotherapyAnthracyclinePathological complete remissionPrognosisHER2 positive breast cancer

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Xiaosong Chen
    • 1
  • Guolin Ye
    • 2
  • Chenfang Zhang
    • 3
  • Xinzheng Li
    • 4
  • Yiding Chen
    • 5
  • Xiaohong Xie
    • 6
  • Hong Zheng
    • 7
  • Yali Cao
    • 8
  • Kejin Wu
    • 9
  • Duo Ni
    • 10
  • Jinhai Tang
    • 11
  • Ziguo Wei
    • 12
  • Kunwei Shen
    • 1
  1. 1.Comprehensive Breast Health Center, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
  2. 2.Department of Breast SurgeryThe First People’s Hospital of FoshanFoshanChina
  3. 3.Department of Breast SurgeryGuangzhou General Hospital of Guangzhou Military AreaGuangzhouChina
  4. 4.Department of Breast SurgeryShanxi Provincial Cancer HospitalTaiyuanChina
  5. 5.Department of Breast SurgeryObstetrics and Gynecology Hospital Affiliated to Zhejiang UniversityHangzhouChina
  6. 6.Department of Breast SurgeryZhejiang Traditional Chinese Medical HospitalHangzhouChina
  7. 7.Department of Breast SurgeryWest China Hospital Sichuan UniversityChengduChina
  8. 8.Department of Breast SurgeryThe Third Hospital of NanchangNanchangChina
  9. 9.Department of Breast Surgery, Xin Hua HospitalShanghai Jiaotong University School of MedicineShanghaiChina
  10. 10.Department of Breast SurgeryXinjiang Uygur Autonomous Region Cancer HospitalXinjiangChina
  11. 11.Department of Breast SurgeryJiangsu Cancer HospitalNanjingChina
  12. 12.Department of Breast and Thyroid SurgeryLinyi People’s HospitalLinyiChina