When do you choose a non-anthracycline containing regimen, such as docetaxel/cyclophosphamide, for patients with hormone receptor positive, HER2 negative breast cancer who warrant adjuvant chemotherapy?
Answer from: Medical Oncologist at Academic Institution
As in many of the decisions we face, we need to balance benefit and risk. Based on the ABC suite of trials, anthracycline regimens are slightly more effective than non-anthracycline (taxane only) regimens. To be clear, the ABC data is far from perfect - the trial design changed at least 3 time...
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Medical Oncologist at Medical College of Wisconsin Would you agree that it is reasonable to consider ...
Answer from: Medical Oncologist at Academic Institution
Looking at the combined data from the ABC trials, the overall benefit of TAC/AC-T over TC was modest - iDFS 90.7% vs. 88.2% (HR 1.23, 95% CI 1.01-1.50) - making the subgroup analysis all the more important to identify patients who are more (and less) likely to benefit from more toxic anthracycline-c...
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Medical Oncologist at Hennepin County Medical Center How would you feel about a middle-aged patient wit...
Answer from: Medical Oncologist at Community Practice
I think in terms of additional benefit of chemo in premenopausal vs postmenopausal, with the added value of the "endocrine effect" of chemotherapy in premenopausal patients. That added effect may be as good as the direct cytotoxic effect and is something to think about.
Generally, in a postmenpausa...
Answer from: Medical Oncologist at Academic Institution
The ABC results provided important data confirming the role of anthracyclines in women with higher risk breast cancer and thus, addressed an important source of ongoing controversy. However, the caveats about the ABC data as outlined @Kathy Miller are greatly appreciated. When chemotherapy is i...
Answer from: Medical Oncologist at Academic Institution
I agree with the comments made by my esteemed colleagues regarding the limitations of the ABC data. There are a few additional nuances that I typically consider. Firstly, one of the criticisms of the TC versus AC (Jones JCO 2006) data was that AC q3weekly was not considered a "gold standard" by many...
Would you agree that it is reasonable to consider ...