Page 188 - Read Online

Elzaafarany et al. J Cancer Metastasis Treat 2018;4:14 Journal of Cancer
DOI: 10.20517/2394-4722.2017.55 Metastasis and Treatment

Review Open Access

The magnitude of benefit from adding taxanes to
anthracyclines in the adjuvant settings of breast
cancer: discussion of large trials and meta-analyses

Osama H. Elzaafarany , Atlal Abusanad 2
1
1 Cancer Management and Research Department, Medical Research Institute-Alexandria University, Alexandria 21561, Egypt.
2 Faculty of Medicine, King Abdulaziz University Hospital, Jeddah 21589, Saudi Arabia.
Correspondence to: Dr. Osama H. Elzaafarany, Cancer Management and Research Department, Medical Research Institute-
Alexandria University, Alexandria 21561, Egypt. E-mail: ossama1@alexu.edu.eg
How to cite this article: Elzaafarany OH, Abusanad A. The magnitude of benefit from adding taxanes to anthracyclines in the adjuvant
settings of breast cancer: discussion of large trials and meta-analyses. J Cancer Metastasis Treat 2018;4:14.
http://dx.doi.org/10.20517/2394-4722.2017.55
Received: 9 Oct 2017 First Decision: 4 Dec 2017 Revised: 6 Mar 2018 Accepted: 8 Mar 2018 Published: 15 Mar 2018

Science Editor: Godefridus J. Peters Copy Editor: Jun-Yao Li Production Editor: Huan-Liang Wu

Abstract
The taxanes family of chemotherapy, which includes paclitaxel and docetaxel, has been incorporated in the adjuvant breast
cancer treatments since 1990s. Sequential and concurrent use of taxanes was investigated with anthracyclines in many
adjuvant early breast cancer randomized clinical trials. Results from taxanes trials showed inconsistent benefits. However,
several meta-analyses showed significant survival benefit of adding taxanes. In this review article, data were collected and
summarized from eleven large randomized trials and three meta-analyses to show and discuss the magnitude of benefit
of taxanes-anthracyclines combination compared to anthracyclines only adjuvant regimens in early breast cancer. This
article aims at providing the oncologists with a well-organized, inclusive and updated evidence.

Keywords: Breast cancer, adjuvant chemotherapy, taxanes, anthracyclines

INTRODUCTION
Adjuvant chemotherapy represents an integral part in the care of breast cancer patients. It has been shown
[1]
that it significantly reduces the risk of recurrence and the risk of death from breast cancer . Adjuvant
chemotherapy in breast cancer has passed through six main eras; the cyclophosphamide, methotrexate,
fluorouracil (CMF)-era, anthracyclines-era, taxanes-era, dose-dense era, combination with targeted therapy
era, and recently the individualized use of chemotherapy based on genetic testing. This article focuses on the
taxanes-era; discussing the large randomized trials (which included more than 1000 patients) [Table 1] and

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

www.jcmtjournal.com