National Cancer Institute’s Breast Intergroup, INT C9741 and CALGB 9741

  • National Cancer Institute’s Breast Intergroup, INT C9741 and CALGB 9741 trial:
    • Was a prospective, randomized trial:
      • Designed to study adjuvant chemotherapy treatment regimens in women with axillary node-positive breast cancer:
        • It was conducted from September 1997 to March 1999
      • Doxorubicin (A), paclitaxel (T), and cyclophosphamide (C) were chosen for this study
  • Using a 2 x 2 factorial design, a total of 2005 patients were randomly assigned to receive 1 of the following regimens:
    • Sequential A then C followed by T x 4 cycles every 3 weeks
    • Dose-dense, sequential A then C then T x 4 cycles every 2 weeks with filgrastim
    • Concurrent AC x 4 cycles followed by T x 4 cycles every 3 weeks
    • Dose-dense, concurrent AC x 4 cycles followed by T x 4 cycles every 2 weeks with filgrastim
  • Results showed:
    • That dose-dense treatment improved the primary endpoints of:
      • DFS and OS:
        • Four-year DFS was:
          • 82% for dose-dense regimens and 75% for other groups:
            • Risk ratio, 0.74, P=0.01
        • Three-year OS:
          • Was 92% for dose-dense regimens and 90% in other groups:
            • Risk ratio, 0.69, P=0.013
        • There was no difference in either DFS or OS:
          • Between the concurrent and sequential schedules
    • Severe neutropenia:
      • Was less common in patients who received:
        • The dose-dense regimens
  • As a result of this study:
    • Dose-dense and concurrent AC chemotherapy has become one of the standard components of breast cancer therapy

REFERENCES

  1. Citron ML, Berry DA, Cirrincione C, et al. Randomized trial of dose-dense versus conventionally scheduled and sequential versus concurrent combination chemotherapy as postoperative adjuvant treatment of node-positive primary breast cancer: first report of Intergroup Trial C9741/Cancer and Leukemia Group B Trial 9741. J Clin Oncol. 2003;21:1431-1439.

#Arrangoiz #Surgeon #BreastSurgeon #BreastCancer #CancerSurgeon #Teacher #SurgicalOncologist

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