Evidence map›Paper›PMID 40801982›Full record

ArticleBreast cancer research and treatment2025

Omission of anthracyclines from neoadjuvant chemotherapy for breast cancer: a population-based analysis.

Danilo Giffoni M M Mata, Rinku Sutradhar, Matthew Castelo, Ezra Hahn, Lena Nguyen, Danielle Rodin, Omolara Fatiregun, Sabina Trebinjac, Lawrence Paszat, Andrea Eisen and 2 more

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Article in Breast cancer research and treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Danilo Giffoni M M MataDivision of Medical Oncology, Verspeeten Family Cancer Centre, London Health Sciences Centre, London, ON, Canada.
Rinku SutradharInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Matthew CasteloDepartment of Surgery, Division of General Surgery, University of Toronto, Toronto, ON, Canada.
Ezra HahnRadiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Lena NguyenInstitute for Clinical Evaluative Sciences, Toronto, ON, Canada.
Danielle RodinRadiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Omolara FatiregunInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Sabina TrebinjacDepartment of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Lawrence PaszatInstitute for Clinical Evaluative Sciences, Toronto, ON, Canada.
Andrea EisenDivision of Medical Oncology, Juravinski Cancer Centre, Hamilton, ON, Canada.
Katarzyna J Jerzak *Department of Medicine, University of Toronto, Toronto, ON, Canada. katarzyna.jerzak@sunnybrook.ca.
Eileen Rakovitch *Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMost individuals diagnosed with high-risk breast cancer are treated with anthracycline-containing neoadjuvant chemotherapy (NAC). There is interest to identify individuals for whom anthracyclines can be avoided. A paucity of data exists on the extent to which anthracyclines are omitted in the neoadjuvant setting and its associated effectiveness.

objectiveTo investigate the extent to which anthracycline-free NAC is used in the treatment of breast cancer and the impact of its omission on risks of mortality.

methodsPopulation-based analysis of individuals diagnosed with stage I-III invasive breast cancer between 2012 and 2021 treated with NAC and surgery in Ontario, Canada. Baseline characteristics of patients who did and did not receive an anthracycline were compared. Five-year cumulative risks of breast cancer and all-cause mortality were calculated. Cause-specific hazard ratios (HRs) and 95% CIs were calculated using adjusted multivariable proportional hazards models for the whole cohort and subsets stratified by stage and receptor subtype.

resultsThe cohort includes 6672 patients; 6126 received an anthracycline, 546 received an anthracycline-free regimen. Median follow-up was 3.9 years. The 5-year cumulative incidence of breast cancer mortality was 12.3% for individuals treated with an anthracycline-free regimen and 14.5% for those who received an anthracycline (p = 0.10). On multivariable analysis, individuals treated with non-anthracycline NAC did not experience an increased risk of breast cancer mortality (HR = 0.88; 95% CI: 0.65,1.18, p = 0.38) or all-cause mortality (HR 0.86; 95% CI 0.67, 1.10, p = 0.23). For patients with stage I or II HER2+ disease, treatment with non-anthracycline NAC was associated with excellent survival.

conclusionsMost individuals treated with NAC received an anthracycline but its omission for selected patients with early HER2+ breast cancer was associated with excellent outcomes.

Indexed as

AnthracyclinesAntineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsNeoadjuvant TherapyAdultAgedChemotherapy, AdjuvantFemaleHumansMiddle AgedNeoplasm StagingOntarioAnthracyclinesAnthracyclineChemotherapyDoxorubicinEarly breast cancerEndocrine receptorEpirubicinHER2NeoadjuvantNon-metastaticTaxane

Identifiers

PMID40801982

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