Reduced Dose Anthracycline Post Breast Cancer Surgery Has No Effect on Outcome

The study, undertaken at the British Columbia Cancer Agency, Vancouver, found that women with early stage breast cancer treated with up to 4 courses of standard adjuvant anthracycline showed no relationship between dose intensity and clinical outcome, despite nearly a decade of follow-up.

Between 1990 and 1995, 484 patients were assessed in 4 groups: 1- all cycles delivered at full dose and on time; 2- one single dose reduction or dose delay; 3- >1 dose reduction or dose delay; and 4- With an average follow-up of 9.6 years, the researchers found no significant differences in relapse-free survival, breast cancer-specific survival, or overall survival between the 4 groups.

Reductions in the dose intensity (DI) of adjuvant anthracycline based chemotherapy in early stage breast cancer are frequently required due to treatment toxicity or poor tolerance, but the implications of a minimal reduction in DI on clinical outcome remain uncertain. Side effects from the therapy can include nausea, fever, weight fluctuations, low white blood cell count and general fatigue.

Lead author Dr Anna Tinker noted that “while there is a breadth of chemotherapy options (e.g. anthracycline based, anthracycline and taxane based, dose dense) the anthracycline based regimen remains a commonly used form of chemotherapy. It may be considered as the sole treatment modality in low risk, endocrine non-responsive disease, or more often, it will form part of a treatment plan such as AC for 4 cycles followed by a taxane, with or with out subsequent hormone therapy or trastuzumab. Therefore, it is important to understand the possible impact of dose modifications of AC therapy on clinical outcomes”.

Recognising a threshold effect of both cumulative dose and dose intensity of anthracyclines, and in light of emerging evidence that dosing schedules may impact on outcome in women with node positive breast cancer, oncologists are often concerned that any single dose modifications or delays will compromise clinical benefit. Oncologists are known to utilise haematopoietic growth factors if dose reductions or delays in adjuvant anthracycline based chemotherapy have been required. Recent data also suggests that chemotherapy dose intensity may be particularly important for patients with ER(-) disease.

However, this retrospective population-based analysis of women with early stage breast cancer treated with up to 4 courses of standard adjuvant AC has not identified a relationship between DI and clinical outcome. When endocrine responsiveness was considered no difference in outcome was appreciated between the 4 groups.

Media Contact

Linda Cairns alfa

All latest news from the category: Health and Medicine

This subject area encompasses research and studies in the field of human medicine.

Among the wide-ranging list of topics covered here are anesthesiology, anatomy, surgery, human genetics, hygiene and environmental medicine, internal medicine, neurology, pharmacology, physiology, urology and dental medicine.

Back to home

Comments (0)

Write a comment

Newest articles

Lighting up the future

New multidisciplinary research from the University of St Andrews could lead to more efficient televisions, computer screens and lighting. Researchers at the Organic Semiconductor Centre in the School of Physics and…

Researchers crack sugarcane’s complex genetic code

Sweet success: Scientists created a highly accurate reference genome for one of the most important modern crops and found a rare example of how genes confer disease resistance in plants….

Evolution of the most powerful ocean current on Earth

The Antarctic Circumpolar Current plays an important part in global overturning circulation, the exchange of heat and CO2 between the ocean and atmosphere, and the stability of Antarctica’s ice sheets….

Partners & Sponsors