Adjuvant epirubicin followed by cyclophosphamide, methotrexate and fluorouracil (CMF) vs CMF in early breast cancer: results with over 7 years median follow-up from the randomised phase III NEAT/BR9601 trials

H. M. Earl, L. Hiller, J. A. Dunn, A-L Vallier, S. J. Bowden, S. D. Jordan, F. Blows, A. Munro, S. Bathers, R. Grieve, D. A. Spooner, R. Agrawal, I. Fernando, A. M. Brunt, S. M. O'Reilly, S. M. Crawford, D. W. Rea, P. Simmonds, J. L. Mansi, A. StanleyK. McAdam, L. Foster, R. C. F. Leonard, C. J. Twelves, D. Cameron, J. M. S. Bartlett, P. Pharoah, E. Provenzano, C. Caldas, C. J. Poole, NEAT Investigators, SCTBG

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: The National Epirubicin Adjuvant Trial (NEAT) and BR9601 trials tested the benefit of epirubicin when added to cyclophosphamide, methotrexate and 5-fluorouracil (E-CMF) compared with standard CMF in adjuvant chemotherapy for women with early breast cancer. This report details longer follow-up with interesting additional time-dependent analyses.

METHODS: National Epirubicin Adjuvant Trial used epirubicin (E) 3-weekly for four cycles followed by classical (c) CMF for four cycles (E-CMF) compared with cCMF for six cycles. BR9601 used E 3-weekly for four cycles followed by CMF 3-weekly for four cycles, compared with CMF 3-weekly for eight cycles.

RESULTS: In all, 2391 eligible patients were randomised and with a median 7.4-year follow-up, E-CMF confirmed a significant benefit over CMF in both relapse-free survival (RFS) (78% vs 71% 5 years RFS, respectively, hazard ratio (HR) = 0.75 (95% CI: 0.65-0.86), P

CONCLUSION: Longer follow-up has confirmed E-CMF as significantly superior to CMF for all patients. Ch17CEP duplication was the only biomarker that demonstrated significant treatment interaction. Standard poor prognostic factors at diagnosis were time-dependent, and after 5 years disease-free, poor prognosis patients demonstrated favourable HRs for survival. British Journal of Cancer (2012) 107, 1257-1267. doi:10.1038/bjc.2012.370 www.bjcancer.com (C) 2012 Cancer Research UK

Original languageEnglish
Pages (from-to)1257-1267
Number of pages11
JournalBritish Journal of Cancer
Volume107
Issue number8
DOIs
Publication statusPublished - Sep 2012

Keywords

  • LIFE
  • breast cancer
  • NEAT
  • THERAPY
  • CHEMOTHERAPY
  • POSITIVE AXILLARY NODES
  • classical CMF
  • adjuvant chemotherapy
  • epirubicin
  • DOXORUBICIN
  • anthracyclines
  • PREMENOPAUSAL WOMEN

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