BCIRG 006: AC vs Taxane Survival Benefit Comparable

Article

A second interimefficacy analysis of BCIRG 006 indicatessimilar survival benefit but significantlyless toxicity with a regimen oftrastuzumab (Herceptin) plus docetaxel(Taxotere), compared with trastuzumabplus doxorubicin.

SAN ANTONIO–A second interimefficacy analysis of BCIRG 006 indicatessimilar survival benefit but significantlyless toxicity with a regimen oftrastuzumab (Herceptin) plus docetaxel(Taxotere), compared with trastuzumabplus doxorubicin (abstract 52). DennisJ. Slamon, MD, PhD, discussed the findings.The international study randomized3,222 HER2-positive women, withor without lymph node involvement(high-risk node-negative), to three treatmentarms: The control group (A)received 4 cycles of doxorubicin andcyclophosphamide (AC) followed by 4cycles of docetaxel (T). Group B receivedthe group A regimen, plus trastuzumab(AC > TH). Group C received 6 cycles ofdocetaxel with carboplatin andtrastuzumab (TCH). The three groupswere well balanced for known cardiovascularrisk factors. One-third of thewomen had 4 or more positive nodes.

The current analysis, with a medianfollow-up of 3 years, found bothtrastuzumab-containing groups weresignificantly superior to the control groupin terms of reduced mortality and improved disease-free survival (DFS). However,the efficacy differences between theanthracycline- vs taxane-containing experimentalregimens were not statisticallysignificant, with a 6% DFS benefitfor AC > TH and a 5% benefit for TCHvs AC > T. Cardiac and leukemia adverseevents were higher in patients on theanthracycline-containing regimens (seeTable 1).

Dr. Slamon said the latest BCIRG 006efficacy analysis shows that "the differencein the number of DFS events andbreast cancer deaths in favor of AC > TH[over TCH], neither of which are statisticallysignificant, is now exceeded bythe number of critical adverse events" inpatients who received the anthracycline,with sustained loss of LVEF (> 10% decline)in 18% of patients on the AC > THarm (vs 8.6% on the TCH arm, P < .0001). The results, he said, warrant carefulconsideration of the future role ofanthracyclines in adjuvant treatment ofbreast cancer.

Related Videos
Barbara Smith, MD, PhD, spoke about the potential use of pegulicianine-guided breast cancer surgery based on reports from the phase 3 INSITE trial.
Patient-reported symptoms following surgery appear to improve with the use of perioperative telemonitoring, says Kelly M. Mahuron, MD.
Treatment options in the refractory setting must improve for patients with resected colorectal cancer peritoneal metastasis, says Muhammad Talha Waheed, MD.
Karine Tawagi, MD, and Sia Daneshmand, MD, with the Oncology Brothers presenting slides
Karine Tawagi, MD, and Sia Daneshmand, MD, with the Oncology Brothers presenting slides
Karine Tawagi, MD, and Sia Daneshmand, MD, with the Oncology Brothers presenting slides
Karine Tawagi, MD, and Sia Daneshmand, MD, with the Oncology Brothers presenting slides
Related Content