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🌱來自: localized breast cancer

Chemotherapy regimens for NAV or ADJ use in HR positive and TNBC-of-localized breast cancer

• 3 most common regimens:
  • CMF (cyclophosphamide, MTX, 5-FU),
  • CAF
  • TC (docetaxel, cyclophosphamide),
  • dd (dose-dense) ACbyT (doxorubicin + cyclophosphamide ×4, followed by paclitaxel ×4 or weekly paclitaxel ×12)
    • Dose dense schedule (q2w) + G-CSF > 3 wk regimen
    • → ↓ of 10-y risk of recurrence or death (Lancet 2019;393:1440-1452)
• Anthracycline (Anthra) & taxane-based tx > TC if HER2(−) & high-risk
  • ABC trial, JCO 2017;35(23): 2647-2655
• If low-risk, TC not < ACT (PlanB, JCO 2019;37(10):799-808)
• CMF:
  • ↑ OS at 30-y follow-up (RR of death = 0.79) vs. no chemo after surgery (BMJ 2005;330:217);
  • not rec for high-risk dz

Highlight

• ↑ DFS & OS w/ anthra containing tx > CMF (EBCTCG, Lancet 2005;365:1687)
• ↑ DFS w/ anthra & T-containing tx > TC × 6 for HER2(−) high-risk pts (ABC trial, JCO 2016;34:1000)
• ↑ DFS & OS when taxane added to anthra-based regimens (EBCTCG Lancet 2012;379:432; NSABP B-28, JCO 2005;23:3686)

Siblings

• Local management with surgery and radiation-of-localized breast cancer
• Hormone positive disease-adjuvant endocrine treatment
• Hormone-positive disease-neoadjuvant therapy-of-localized breast cancer
• HER2-positive disease-of-localized breast cancer
• Considerations for young patients-of-localized breast cancer