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Tailored Dose-Dense Versus Standard Adjuvant Chemotherapy for High-Risk Early Breast Cancer: End-of-Study Results of the Randomized PANTHER Trial

Matikas, A. ; Malmström, P. LU and Bergh, Jonas (2024) In Journal of Clinical Oncology 42(26). p.3077-3082
Abstract
Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.Although dose-dense adjuvant chemotherapy administered once every 2 weeks leads to superior outcomes compared with standard regimens once every 3 weeks, the observed improvement is largely limited to studies using the suboptimal paclitaxel schedule once every 3 weeks as control. PANTHER is an international phase III trial... (More)
Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.Although dose-dense adjuvant chemotherapy administered once every 2 weeks leads to superior outcomes compared with standard regimens once every 3 weeks, the observed improvement is largely limited to studies using the suboptimal paclitaxel schedule once every 3 weeks as control. PANTHER is an international phase III trial which compared sequential epirubicin/cyclophosphamide and docetaxel administered either once every 2 or once every 3 weeks, with tailored dosing at the dose-dense schedule according to hematologic toxicity. In this end-of-study analysis, the median follow-up was 10.3 years. Compared with standard adjuvant chemotherapy, dose-dense treatment improved breast cancer recurrence-free survival (hazard ratio [HR], 0.80 [95% CI, 0.65 to 0.98]; P =.030), event-free survival (HR, 0.78 [95% CI, 0.65 to 0.94]; P =.009), and distant disease-free survival (HR, 0.79 [95% CI, 0.64 to 0.98]; P =.030) while the improvement in overall survival was not statistically significant (HR, 0.82 [95% CI, 0.65 to 1.04]; P =.109). To our knowledge, this is the first trial that confirms the benefit of a dose-dense regimen over a control regimen containing docetaxel once every 3 weeks. © American Society of Clinical Oncology. (Less)
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type
Contribution to journal
publication status
published
subject
in
Journal of Clinical Oncology
volume
42
issue
26
pages
6 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:85201068880
  • pmid:39018515
ISSN
0732-183X
DOI
10.1200/JCO.24.00178
language
English
LU publication?
yes
id
9ed54245-c729-4955-86e1-ea787db28a25
date added to LUP
2024-10-03 16:11:56
date last changed
2025-04-04 14:15:31
@article{9ed54245-c729-4955-86e1-ea787db28a25,
  abstract     = {{Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.Although dose-dense adjuvant chemotherapy administered once every 2 weeks leads to superior outcomes compared with standard regimens once every 3 weeks, the observed improvement is largely limited to studies using the suboptimal paclitaxel schedule once every 3 weeks as control. PANTHER is an international phase III trial which compared sequential epirubicin/cyclophosphamide and docetaxel administered either once every 2 or once every 3 weeks, with tailored dosing at the dose-dense schedule according to hematologic toxicity. In this end-of-study analysis, the median follow-up was 10.3 years. Compared with standard adjuvant chemotherapy, dose-dense treatment improved breast cancer recurrence-free survival (hazard ratio [HR], 0.80 [95% CI, 0.65 to 0.98]; P =.030), event-free survival (HR, 0.78 [95% CI, 0.65 to 0.94]; P =.009), and distant disease-free survival (HR, 0.79 [95% CI, 0.64 to 0.98]; P =.030) while the improvement in overall survival was not statistically significant (HR, 0.82 [95% CI, 0.65 to 1.04]; P =.109). To our knowledge, this is the first trial that confirms the benefit of a dose-dense regimen over a control regimen containing docetaxel once every 3 weeks.  © American Society of Clinical Oncology.}},
  author       = {{Matikas, A. and Malmström, P. and Bergh, Jonas}},
  issn         = {{0732-183X}},
  language     = {{eng}},
  number       = {{26}},
  pages        = {{3077--3082}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Journal of Clinical Oncology}},
  title        = {{Tailored Dose-Dense Versus Standard Adjuvant Chemotherapy for High-Risk Early Breast Cancer: End-of-Study Results of the Randomized PANTHER Trial}},
  url          = {{http://dx.doi.org/10.1200/JCO.24.00178}},
  doi          = {{10.1200/JCO.24.00178}},
  volume       = {{42}},
  year         = {{2024}},
}