Sis just got diagnosed looking for treatment regiment.

nnguyen

Hello, my sister just got diagnosed with IDC. Her disease characteristics are: tumor size 3cm+, ER+, PR+, Her2-, nuclear grade 2 (medium), node negative. She may be at stage 1B or 2. She had a lumpectomy. Most likely she will receive radiation, chemo (waiting for Oncotype DX result), and hormonal treatment. I am looking for latest standard of care (for this stage) with specific drug names for chemotherapy, hormonal, and radiation delivery technique (whole breast, chest, high dose but short duration, or low dose but frequent, etc).

What are names of medicine that you are being treated with? If you happen to have link to abstracts demonstrating the reason why it was being given to you would be great. I have found the below for chemo, though I am not sure it is the latest. For hormonal, I have not find definitive data to decide between tamoxifen, exemestance, anastrozole, or letrozole.

Many thanks for your data.

Nguyen

Effectiveness of an Adjuvant Chemotherapy Regimen for Early-Stage Breast Cancer: A Systematic Review and Network Meta-analysis.

Fujii T¹, Le Du F², Xiao L³, Kogawa T², Barcenas CH², Alvarez RH², Valero V², Shen Y³, Ueno NT².

Author information

Abstract

IMPORTANCE:

Different adjuvant chemotherapy regimens are available for early-stage breast cancer. Because conventional meta-analysis does not allow comparing all regimens, we performed a network meta-analysis to identify the most effective adjuvant chemotherapy regimen.

OBJECTIVE:

To find the most effective adjuvant therapy regimen for early-stage breast cancer.

DATA SOURCES:

We searched MEDLINE, Embase, and the Cochrane Library for articles published before June 2015; the American Society of Clinical Oncology annual meeting abstracts from January 1983 through December 2014; and the American Association for Cancer Research annual meeting abstracts from January 1916 through December 2014. Additionally, we manually searched bibliographies for related references.

STUDY SELECTION:

We included randomized clinical trials of adjuvant treatments for early-stage breast cancer that compared 2 or more of the following: no adjuvant chemotherapy; sequential anthracycline-cyclophosphamide and taxane (AC-T); concurrent anthracycline-cyclophosphamide and taxane (ACT); anthracycline-cyclophosphamide without taxane (AC); docetaxel and cyclophosphamide (TC); cyclophosphamide, methotrexate, and fluorouracil (CMF); and platinum-containing regimens.

DATA EXTRACTION AND SYNTHESIS:

We followed the PRISMA guidelines. Two investigators independently selected the articles and extracted information. Disagreements were resolved by discussion with another author. Quality was assessed by Cochrane risk-of-bias method. Data were pooled using random-effects models.

MAIN OUTCOMES AND MEASURES:

We used network meta-analysis to test the most effective adjuvant therapy regimen in terms of overall survival (OS) by comparing regimens listed in the National Comprehensive Cancer Network guidelines and platinum-containing regimens.

RESULTS:

We identified 24 trials. The TC and platinum-containing regimens had OS benefit similar to that of sequential AC-T (TC hazard ratio [HR], 0.93; 95% CI, 0.62-1.40; and platinum HR, 0.93; 95% CI, 0.66-1.31). Patients treated with CMF or AC had significantly worse OS than those treated with sequential AC-T (CMF HR, 1.56; 95% CI, 1.32-1.85; and AC HR, 1.22; 95% CI, 1.10-1.37). Platinum-containing regimens tended to be more toxic than sequential AC-T. The toxicity of TC was similar to or less than that of sequential AC-T. Meta-regression analysis showed that hormone receptor status did not impact the HRs for OS for any regimen.

CONCLUSIONS AND RELEVANCE:

Sequential AC-T is likely to be the most effective adjuvant therapy regimen for early-stage breast cancer regardless of hormone receptor status.