Taxanes with anthracyclines as first-line chemotherapy for metastatic breast carcinoma: Pooled analysis of 2805 patients

Emilio Bria, Diana Giannarelli, Alessandra Felici, William P. Peters, Cecilia Nisticò, Barbara Vanni, Federica Cuppone, Francesco Cognetti, Edmondo Terzoli

Research output: Contribution to journalArticle

Abstract

BACKGROUND. The magnitude of the benefit of adding taxanes to anthracyclines in first-line chemotherapy for metastatic breast carcinoma is still unclear. The authors performed a pooled analysis as well as a meta-analysis of all Phase III trials, to determine whether the combination of anthracyclines plus taxanes provided an advantage over standard anthracyclines-based regimens. METHODS. All Phase III peer-reviewed published or presented trials were considered eligible. A pooled analysis (Method A) and a literature-based meta-analysis (Method B) were accomplished, and event-based relative risk ratios (RRA-B) with 95% confidence intervals were derived. Both analyses were performed to examine for significant differences in time to disease progression (TTP), overall response rate (ORR), overall survival (OS), complete response rate (CR), neutropenia, and febrile neutropenia (FN). For both analyses, a heterogeneity test was applied. RESULTS. Seven trials (2805 patients) were gathered. When data were pooled and plotted, significant differences in favor of taxanes were seen for ORR (RRA-B 1.21, P <0.001), CR (RRA 2.04; RRB 1.81, P <0.001), even though they caused a significant increase in neutropenia (RRA 1.19; RRB 1.15, P <0.001) and FN (RRA 2.82; RRB 3.44, P <0.001). A borderline significance in favor of taxanes was seen in TTP (RRA 1.10, P = 0.05; RRB 1.06, P = 0.07). A nonsignificant trend for taxanes was found in OS. No significant heterogeneity (except for neutropenia, P <0.01) was observed. CONCLUSIONS. The adjunction of taxanes to anthracyclines in first-line chemotherapy for metastatic breast carcinoma yielded a significant benefit in activity (ORR, CR), a slight advantage in TTP, and a trend in OS, although with a significant cost in hematologic toxicity.

Original languageEnglish
Pages (from-to)672-679
Number of pages8
JournalCancer
Volume103
Issue number4
DOIs
Publication statusPublished - Feb 15 2005

Keywords

  • Breast carcinoma
  • Docetaxel
  • Meta-analysis
  • Paclitaxel

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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