Comparison of chemotherapeutic combination therapy, dosing frequency and dosing sequence for the adjuvant treatment of early-stage breast cancer: a network meta-analysis.
Linxiaoxi Ma, Wenjia Zuo, Yizi Zheng et al.
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In 30 seconds
This network meta-analysis compared adjuvant chemotherapy regimens, dosing frequency and sequence for women with early-stage breast cancer. It included 17,187 patients from 36 randomised controlled trials, with follow-up ranging from 22 to 152 months (median 12.8 years). The regimen of concurrent taxane and cyclophosphamide for six cycles had the highest ranking for event-free survival (SUCRA 0.95); sequential anthracycline/cyclophosphamide followed by taxane ranked highest for overall survival (SUCRA 0.92). The authors concluded that concurrent taxane and cyclophosphamide every three weeks might be optimal.
Key findings
- Concurrent six-cycle taxane and cyclophosphamide had the highest event-free survival ranking (SUCRA: 0.95).
- Four cycles of anthracycline/cyclophosphamide followed by taxane ranked highest for overall survival (SUCRA: 0.92).
- AQD ranked lowest for nausea incidence (SUCRA: 0.96), while C ranked lowest for neutropenia (SUCRA: 0.79).
Why it matters
The analysis compares both efficacy and selected severe adverse effects across adjuvant chemotherapy strategies, highlighting that the regimen ranked highest for event-free survival was not the one ranked highest for overall survival. These comparative rankings can inform interpretation of regimen trade-offs, while remaining dependent on the trials and outcomes included in the network.
What to keep in mind
The analysis combines trials with follow-up ranging from 22 to 152 months, and rankings across regimens do not establish that one strategy is definitively superior for every patient or outcome.