Efficacy
CALGB 9741 trial
After a median follow-up of 36 months, the dose dense treatment improved DFS (risk ratio (RR) = 0.74; p = 0.01) and OS (RR = 0.69; p = 0.013)
4 year DFS was 82% for the dose dense regimens and 75% for the others.
There was no difference in DFS or OS between concurrent and sequential regimens.r
© Journal of Clinical Oncology 2003
EBCTCG meta-analysis
A meta-analysis by the EBCTCG demonstrated a lower 10 year risk of recurrence with dose-intense chemotherapy compared with standard-schedule chemotherapy (28.0% vs 31.4%, RR 0.86, 95% CI 0.82 to 0.89; p<0.0001). Dose-intense chemotherapy was also associated with lower 10 year breast cancer mortality rates (18.9% vs 21.3% respectively; RR 0.87, 95% CI 0.83 to 0.92; p<0·0001) and all-cause mortality (22.1% vs 24.8% respectively; RR 0.87, 95% CI 0.83 to 0.91; p<0·0001). The proportional reductions in recurrence with dose-intense chemotherapy were similar in oestrogen receptor (ER)-positive and ER-negative disease (p<0·0001) and did not differ significantly by other patient or tumour characteristics.r
Pooled analysis of all dose-intensification trials for 10 year cumulative risk of any recurrence (A), breast cancer mortality (B), death without recurrence (C), and all-cause mortality (D) for dose-intense vs standard-schedule chemotherapy groupsr
© Lancet 2019