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Emergence of nonanthracycline regimens in the adjuvant treatment of breast cancer

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Abstract

Long-term toxicity of adjuvant regimens is a critical consideration given improvements in survival and consequential management of treatment-related side effects. Despite their well-documented long-term side effects, including a cumulative dose-dependent cardiotoxicity and an increase in the incidence of secondary leukemia, anthracyclines remain an integral component of many adjuvant regimens for breast cancer. The utility of HER-2/TOP2A coamplification in predicting sensitivity to anthracycline chemotherapy has been widely suggested but requires substantiation. The recent maturation of two large phase III trials that directly examined the substitution of a taxane for an anthracycline in the adjuvant setting provides further data to critically evaluate the standard use of anthracyclines in the treatment of early-stage breast cancer. Results from both US Oncology 9735 and BCIRG 006 demonstrated equivalent efficacies in taxane- and anthracycline comparator arms. However, in both trials, the taxane-based regimen(s) resulted in less relative toxicity than the anthracycline-based regimen(s). These trial results pose legitimate questions regarding the future application of anthracyclines in the adjuvant breast cancer setting.

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Acknowledgments

Editorial support was provided by Fiona Herr, PhD, and was funded by sanofi-aventis US. The authors are fully responsible for all content and editorial decisions and did not receive financial support or compensation related to the development of the manuscript.

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  1. Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA, 91010, USA

    Sumanta K. Pal

  2. Sanofi-aventis US, Bridgewater, NJ, USA

    Barrett H. Childs

  3. University of Miami, Miami, FL, USA

    Mark Pegram

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Correspondence to Sumanta K. Pal.

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Pal, S.K., Childs, B.H. & Pegram, M. Emergence of nonanthracycline regimens in the adjuvant treatment of breast cancer. Breast Cancer Res Treat 119, 25–32 (2010). https://doi.org/10.1007/s10549-009-0567-y

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