Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Nov;3(19):284.
doi: 10.3978/j.issn.2305-5839.2015.11.14.

Metronomic methotrexate and cyclophosphamide after carboplatin included adjuvant chemotherapy in triple negative breast cancer: a phase III study

Khalid E Nasr  1 , Mohammed A Osman  1 , Mohammad S Elkady  1 , Mahmoud A Ellithy  1
Affiliations

Metronomic methotrexate and cyclophosphamide after carboplatin included adjuvant chemotherapy in triple negative breast cancer: a phase III study

Khalid E Nasr et al. Ann Transl Med. 2015 Nov.

Abstract

Background: Despite being chemosensitive, the majority of triple negative breast cancer (TNBC) patients recur. The primary study objectives were to compare disease free survival (DFS), and overall survival (OS) for TNBC after adjuvant chemotherapy, who underwent maintenance metronomic chemotherapy versus no maintenance therapy.

Methods: TNBC patients were eligible for enrolment if they had TNM stages II-III and fit with our inclusion criteria. Patients were assigned to either: group 1, 3 cycles FEC-100 then 3 cycles docetaxel, carboplatin, followed by maintenance metronomic chemotherapy for 1 year; and group 2, 3 cycles FEC-100 then 3 cycles docetaxel.

Results: Between November 2008 and December 2014, 158 patients (78 group 1, and 80 group 2) were enrolled. The mean age was 46 years. The median DFS for groups 1,2 were 28 and 24 months, respectively; P value 0.05. The median OS for groups 1,2 were 37 and 29 months, respectively; P values 0.04. Additionally, during the follow-up period, the overall distant metastasis recurrence rates for groups 1,2 were 26% and 37% respectively. Finally, treatment protocol was tolerated well in both groups with mild toxicity profiles.

Conclusions: Extended adjuvant metronomic chemotherapy achieved significant improvement in the survival and was well tolerated.

Keywords: Triple-negative breast cancer (TNBC); adjuvant; carboplatin; chemotherapy; disease free survival (DFS); metronomic; overall survival (OS); toxicity.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: Part of the study was presented in American Society of Clinical Oncology (ASCO) Annual Meeting, May 2015, USA, and subsequently published in the J Clin Oncol 33, 2015 (suppl; abstr e12087).

Figures

Figure 1
Figure 1
Treatment protocol of the current study.
Figure 2
Figure 2
The DFS for the study group—P value: 0.05. DFS, disease free survival.
Figure 3
Figure 3
The OS for the study group—P value 0.03. OS, overall survival.
See this image and copyright information in PMC

References

    1. Foulkes WD, Smith IE, Reis-Filho JS. Triple-negative breast cancer. N Engl J Med 2010;363:1938-48. - PubMed
    1. Dent R, Trudeau M, Pritchard KI, et al. Triple-negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res 2007;13:4429-34. - PubMed
    1. Lin NU, Vanderplas A, Hughes ME, et al. Clinicopathological features and sites of recurrence according to breast cancer subtype in the National Comprehensive Cancer Network (NCCN). J Clin Oncol 2009;27:abstr 543.
    1. Dawood S, Broglio K, Esteva FJ, et al. Survival among women with triple receptor-negative breast cancer and brain metastases. Ann Oncol 2009;20:621-7. - PMC - PubMed
    1. Irvin WJ, Jr, Carey LA. What is triple-negative breast cancer? Eur J Cancer 2008;44:2799-805. - PubMed