PURPOSE: To review data relating to anthracyclines in the adjuvant treatment of early breast cancer. DESIGN: This is a report from a seminar in which the future of anthracyclines in the adjuvant treatment of breast cancer was considered. In particular, the question of whether anthracyclines should now be discarded and replaced by taxanes was addressed. RESULTS: Accumulating data from large randomized trials indicate that genetic markers may have a role in predicting sensitivity to cytotoxic drugs. However, no reliable, validated test is available for predicting sensitivity to anthracyclines in particular. Topoisomerase IIalpha amplification and/or deletion, especially in conjunction with human epidermal growth factor receptor-2 amplification, has been proposed to fulfill this role but more data are needed. Currently, only one published trial has shown that a taxane-based regimen may be superior to an anthracycline-based regimen, but several trials indicate that combinations including both anthracyclines and taxanes may be better still. Further studies aimed at optimizing anthracyclines and taxanes in combination, and integrating biologic agents, seem to be the way forward. There is no validated test that can determine whether anthracyclines can be of greater benefit than other agents for individual patients. CONCLUSION: Anthracyclines have been extensively tested in clinical trials spanning several decades; currently, there are insufficient data to recommend replacing them in the adjuvant treatment of breast cancer.
PURPOSE: To review data relating to anthracyclines in the adjuvant treatment of early breast cancer. DESIGN: This is a report from a seminar in which the future of anthracyclines in the adjuvant treatment of breast cancer was considered. In particular, the question of whether anthracyclines should now be discarded and replaced by taxanes was addressed. RESULTS: Accumulating data from large randomized trials indicate that genetic markers may have a role in predicting sensitivity to cytotoxic drugs. However, no reliable, validated test is available for predicting sensitivity to anthracyclines in particular. Topoisomerase IIalpha amplification and/or deletion, especially in conjunction with humanepidermal growth factor receptor-2 amplification, has been proposed to fulfill this role but more data are needed. Currently, only one published trial has shown that a taxane-based regimen may be superior to an anthracycline-based regimen, but several trials indicate that combinations including both anthracyclines and taxanes may be better still. Further studies aimed at optimizing anthracyclines and taxanes in combination, and integrating biologic agents, seem to be the way forward. There is no validated test that can determine whether anthracyclines can be of greater benefit than other agents for individual patients. CONCLUSION:Anthracyclines have been extensively tested in clinical trials spanning several decades; currently, there are insufficient data to recommend replacing them in the adjuvant treatment of breast cancer.
Authors: Gabrielle Rocque; Adedayo Onitilo; Jessica Engel; Erica Pettke; Alice Boshoven; Kyungmann Kim; Shailly Rishi; Bonnie Waack; Kari B Wisinski; Amye Tevaarwerk; Mark E Burkard Journal: Breast Cancer Res Treat Date: 2011-11-08 Impact factor: 4.872
Authors: Harold J Burstein; Martine J Piccart-Gebhart; Edith A Perez; Gabriel N Hortobagyi; Norman Wolmark; Kathy S Albain; Larry Norton; Eric P Winer; Clifford A Hudis Journal: J Clin Oncol Date: 2012-05-21 Impact factor: 44.544
Authors: Carlos H Barcenas; Jiangong Niu; Ning Zhang; Yufeng Zhang; Thomas A Buchholz; Linda S Elting; Gabriel N Hortobagyi; Benjamin D Smith; Sharon H Giordano Journal: J Clin Oncol Date: 2014-05-27 Impact factor: 44.544
Authors: Jessica E Pritchard; Patrick M Dillon; Mark R Conaway; Corinne M Silva; Sarah J Parsons Journal: Oncology Date: 2012-09-05 Impact factor: 2.935