Dose-Dense Chemotherapy No Better than Standard Chemotherapy in Early Breast Cancer

Women with high-risk early breast cancer did not achieve a statistically significant improvement from tailored dose-dense chemotherapy compared with standard adjuvant chemotherapy.

Dose-dense chemotherapy administers patients anti-cancer drugs at shorter intervals without increasing the cumulative dose. This method has been suggested as a means to improve the efficacy of chemotherapy for early breast cancer.

In a study published in JAMA, researchers sought to determine whether tailored dose-dense chemotherapy could improve outcomes compared with standard adjuvant chemotherapy.

The study was conducted at 86 sites in Sweden, Austria, and Germany, and included 2017 women who had surgery for non-metastatic node-positive or high-risk node-negative breast cancer. Patients were randomized to receive either tailored dose-dense adjuvant chemotherapy (n=1006) or standard chemotherapy (n=1011).

Among the randomized patients, there were 2000 who received study treatment of at least 1 cycle of chemotherapy. Additionally, the median follow-up time was 5.3 years.

The results of the study showed that the groups did not differ in 5-year breast cancer recurrence-free survival, with 89% in the tailored dose-dense group and 85% in the control group. The 5-year overall survival was 92% versus 90%, respectively, while the 5-year distant disease-free survival was 89% versus 87%, respectively.

For 5-year event-free survival (EFS), the tailored dose-dense group was found to be significantly better than the control group (87% versus 82% respectively).

It’s important to note that grade 3 or 4 nonhematologic toxic effects occurred in 53% of patients in the tailored dose-dense group and 37% in the control group.

The authors noted that an individual patient data meta-analysis would help assess if chemotherapy dose intensification in early breast cancer should be used for specific subgroups of patients.