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The Omission of Anthracycline Chemotherapy in Women with Early HER2-Negative Breast Cancer—A Systematic Review and Meta-Analysis

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Background: Anthracycline-taxane is the standard chemotherapy strategy for treating high-risk early breast cancer despite the potentially life-threatening adverse events caused by anthracyclines. Commonly, the combination of docetaxel and cyclophosphamide (TC) is considered an alternative option. However, the efficacy of TC compared to anthracycline-taxane chemotherapy is unclear. This study compares disease-free survival (DFS), overall survival (OS) and cardiotoxicity between adjuvant TC and anthracycline-taxane for stages I–III, HER2-negative breast cancer. Methods: A systematic search on MEDLINE, Embase and Cochrane CENTRAL for randomized-controlled trials published until 11 March 2024, yielded 203 studies with 11,803 patients, and seven trials were included. Results: TC results in little to no difference in DFS (HR 1.09, 95% CI 0.98–1.20; moderate-certainty of evidence); OS (1.02, 95% CI 0.89–1.16; high-certainty of evidence); and cardiotoxicity (RR 0.54, 95% CI 0.16–1.76; high-certainty of evidence), compared to anthracycline-taxane. In the subgroup analysis, patients with ≥4 lymph nodes had improved DFS from anthracycline-taxane over TC. Conclusions: Overall, there was no difference between TC and anthracycline-taxane in DFS, OS and cardiotoxicity. In women with ≥4 nodes, anthracycline-taxane was associated with a substantial reduction in relapse events, compared to TC. Our study supports the current standard of practice, which is to use anthracycline-taxane and TC chemotherapy as a reasonable option in select cases.

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Podemos omitir a antraciclina em que situações finalissima

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Cancer - 2023 - Vannier - Validation of the RSClin risk calculator in the National Cancer Data Base

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Clinical Manifestation Monitoring 2022 cardiotoxic antitumor frontiers

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Breast cancer  pathogenesis and treatments nature 2025

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Tumor biomarkers for diagnosis prognosis and targeted terapia 2024

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Podemos omitir a antraciclina em que situações AGO 25

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https://breast.predict.nhs.uk

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,FERRAMENTA RSCLIN

https://rsclin.genomichealth.com/#/

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A monthly publication of the Brazilian Society of Cardiology and considered the main channel for the promotion of Brazilian cardiovascular research.