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

被引：15

作者：

Earl, H. M. ^{[1
,2
,3
]}

Hiller, L. ^{[4
]}

Dunn, J. A. ^{[4
]}

Vallier, A-L ^{[5
]}

Bowden, S. J. ^{[6
]}

Jordan, S. D. ^{[6
]}

Blows, F. ^{[1
]}

Munro, A. ^{[7
]}

Bathers, S. ^{[6
]}

Grieve, R. ^{[8
]}

Spooner, D. A. ^{[9
]}

Agrawal, R. ^{[10
]}

Fernando, I. ^{[9
]}

Brunt, A. M. ^{[11
]}

O'Reilly, S. M. ^{[12
]}

Crawford, S. M. ^{[13
]}

Rea, D. W. ^{[6
]}

Simmonds, P. ^{[14
]}

Mansi, J. L. ^{[15
,16
]}

Stanley, A. ^{[15
]}

McAdam, K. ^{[1
,17
]}

Foster, L. ^{[18
]}

Leonard, R. C. F. ^{[19
]}

Twelves, C. J. ^{[20
]}

Cameron, D. ^{[21
]}

Bartlett, J. M. S. ^{[7
]}

Pharoah, P. ^{[22
]}

Provenzano, E. ^{[1
,2
,3
]}

Caldas, C. ^{[1
,2
,3
]}

Poole, C. J. ^{[23
]}

机构：

[1] Univ Cambridge, Addenbrookes Hosp, Dept Oncol, Cambridge CB2 0QQ, England

[2] Cambridge Expt Canc Med Ctr, Cambridge CB2 0QQ, England

[3] NIHR Cambridge Biomed Res Ctr, Cambridge CB2 0QQ, England

[4] Univ Warwick, Warwick Clin Trials Unit, Coventry CV4 7AL, W Midlands, England

[5] Addenbrookes Hosp, Cambridge Clin Trials Ctr, Dept Oncol, Cambridge CB2 0QQ, England

[6] Univ Birmingham, Canc Res UK Clin Trials Unit, Inst Canc Studies, Birmingham B15 2TT, W Midlands, England

[7] Univ Edinburgh, Endocrine Canc Grp, Edinburgh EH4 2XU, Midlothian, Scotland

[8] Univ Hosp Coventry & Warwickshire, Arden Canc Ctr, Coventry CV1 2GQ, W Midlands, England

[9] Queen Elizabeth Hosp, Ctr Canc, Birmingham B15 2TH, W Midlands, England

[10] Royal Shrewsbury Hosp, Shrewsbury SY3 8XQ, Shrops, England

[11] Univ Hosp N Staffordshire, Stoke On Trent ST4 7LN, Staffs, England

[12] Clatterbridge Hosp, Wirral CH63 4JY, Merseyside, England

[13] Airedale Dist Gen Hosp, Keighley BD20 6TD, W Yorkshire, England

[14] Royal S Hampshire Hosp, Southampton SO14 0YG, Hants, England

[15] Guys & St Thomas Hosp NHS Fdn Trust, Dept Oncol, London SE1 7EH, England

[16] NIHR Kings Coll London Biomed Res Ctr, London SE1 7EH, England

[17] Peterborough City Hosp, Peterborough PE3 9GZ, Cambs, England

[18] Scottish Canc Therapy Network, Edinburgh, Midlothian, Scotland

[19] Charing Cross Hosp, London W6 8RF, England

[20] Univ Leeds, Canc Res UK Clin Ctr, Leeds LS9 7TF, W Yorkshire, England

[21] Western Gen Hosp, Edinburgh Canc Res Ctr, Edinburgh EH4 2XR, Midlothian, Scotland

[22] Strangeways Res Lab, Cambridge CB1 8RN, England

[23] Clin Sci Res Inst, Dept Med Oncol, Coventry CV2 2DX, W Midlands, England

来源：

BRITISH JOURNAL OF CANCER | 2012年 / 107卷 / 08期

关键词：

NEAT; breast cancer; adjuvant chemotherapy; anthracyclines; epirubicin; classical CMF; PREMENOPAUSAL WOMEN; CHEMOTHERAPY; DOXORUBICIN;

D O I：

10.1038/bjc.2012.370

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 [肿瘤学];

摘要：

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<0.0001) and overall survival (OS) (84% vs 78% 5 years OS, respectively, HR = 0.76 (95% CI: 0.65-0.89), P = 0.0007). Interaction of treatment effect and prognostic factors was demonstrated for duplication of chromosome 17 centromeric enumeration (Ch17CEP) as previously reported. Poor prognostic factors at diagnosis (ER and PR negative and HER2 positive) showed time-dependent annual hazard rates for RFS and OS. In univariate analysis, these factors demonstrated more favourable HRs for RFS after 5 years. Treatment effects also suggested a differential benefit for E-CMF within the first 5 years for poor prognosis tumours. 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

引用

页码：1257 / 1267

页数：11

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